室间隔缺损合并缺陷乏养菌致感染性心内膜炎——附1例报告  

Ventricular septal defect with infective endocarditis caused by Abiotrophia defectiva:a case report

作　　者：郑双林 马芳芳 王莹莹 谢华斌 Zheng Shuanglin;Ma Fangfang;Wang Yingying;Xie Huabin(Department of Clinical Laboratory,Xiamen University Affiliated Cardiovascular Hospital,Xiamen 361000,Fujian,China)

机构地区：[1]厦门大学附属心血管病医院检验科,福建厦门361000

出　　处：《实用检验医师杂志》2023年第3期329-332,共4页Chinese Journal of Clinical Pathologist

基　　金：福建省厦门市医疗卫生指导性项目(3502Z20209142,3502Z20224ZD1193)。

摘　　要：目的报告1例室间隔缺损合并缺陷乏养菌致感染性心内膜炎(IE)患者的诊疗过程。方法回顾并分析厦门大学附属心血管病医院收治的1例先天性室间隔缺损合并IE患者的临床资料以及治疗方案,采用微生物检验与临床诊断相结合的方法,收集患者外周静脉血样本及术中切除的瓣膜赘生物标本进行微生物培养。结果患者为54岁女性,因“反复胸痛3年,再发1个月余”于2021年10月12日入院。入院心脏彩超显示为室间隔缺损,肺动脉瓣上可见长约12.7 mm的赘生物,其外周血及瓣膜赘生物标本均培养出缺陷乏养菌。经抗感染、外科手术治疗,患者好转出院。结论缺陷乏养菌作为正常菌群,当机体免疫力低下时经由血行途径成为致病菌,尤其当患者存在先天性心脏病等危险因素时,会引起IE。Objective To report the diagnosis and treatment of a case of ventricular septal defect with infective endocarditis(IE)caused by Abiotrophia defectiva.Methods The clinical data and treatment plan of a patient with congenital ventricular septal defect complicated with IE admitted to Xiamen University Affiliated Cardiovascular Hospital were reviewed and analyzed.Using a combination of microbiological testing and clinical diagnosis,the peripheral venous blood samples and valve vegetation samples removed during surgery for microbial culture were collected.Results The patient was a 54-year-old female and admitted to the hospital on October 12,2021 due to"repeated chest pain for 3 years and recurring for more than 1 month".On admission,ventricular septal defect was revealed by color Doppler ultrasound,and a 12.7 mm long neoplasm was observed on the pulmonary valve.Abiotrophia defectiva was cultured in peripheral blood and valvular vegetation specimens.After anti-infection and surgical treatment,the patient was discharged with improvement.Conclusion As a normal flora,Abiotrophia defectiva become pathogenic bacteria through the hematogenous route when the immunity is low,especially when there are risk factors such as congenital heart disease that could cause IE.

关 键 词：室间隔缺损 缺陷乏养菌 感染性心内膜炎 血培养 赘生物 

分 类 号：R542.41[医药卫生—心血管疾病]