BMC Infectious Diseases | |
Non-nosocomial healthcare-associated left-sided Pseudomonas aeruginosa endocarditis: a case report and literature review | |
Case Report | |
Kohei Takimoto1  Takeshi Tanaka2  Norihisa Yamamoto3  Hideharu Hagiya3  Hisao Yoshida3  Kazunori Tomono3  Yukihiro Akeda3  | |
[1] Department of Anesthesiology and Intensive Care Medicine, Osaka University Hospital, Osaka, Japan;Department of Cardiovascular Surgery, Osaka University Hospital, Osaka, Japan;Division of Infection Control and Prevention, Osaka University Hospital, 2-15 Yamadaoka, Suita, 565-0871, Osaka, Japan; | |
关键词: Healthcare-associated infective endocarditis; Patent foramen ovale; Right-to-left shunt; Urethral self-catheterization; | |
DOI : 10.1186/s12879-016-1757-y | |
received in 2015-10-20, accepted in 2016-08-04, 发布年份 2016 | |
来源: Springer | |
【 摘 要 】
BackgroundWith the development of invasive medical procedures, an increasing number of healthcare-associated infective endocarditis cases have been reported. In particular, non-nosocomial healthcare-associated infective endocarditis in outpatients with recent medical intervention has been increasingly identified.Case presentationA 66-year-old man with diabetes mellitus and a recent history of intermittent urethral self-catheterization was admitted due to a high fever. Repeated blood cultures identified Pseudomonas aeruginosa, and transesophageal echocardiography uncovered a new-onset severe aortic regurgitation along with a vegetative valvular structure. The patient underwent emergency aortic valve replacement surgery and was successfully treated with 6 weeks of high-dose meropenem and tobramycin. Historically, most cases of P. aeruginosa endocarditis have occurred in the right side of the heart and in outpatients with a history of intravenous drug abuse. In the case presented, the repeated manipulations of the urethra may have triggered the infection. Our literature review for left-sided P. aeruginosa endocarditis showed that non-nosocomial infection accounted for nearly half of the cases and resulted in fatal outcomes as often as nosocomial cases. A combination therapy with anti-pseudomonal beta-lactams or carbapenems and aminoglycosides may be the preferable treatment. Medical treatment alone may be effective, and surgical treatment should be carefully considered.ConclusionsWe presented a rare case of native aortic valve endocarditis caused by P. aeruginosa. This case illustrates the importance of identifying the causative pathogen(s), especially for outpatients with a recent history of medical procedures.
【 授权许可】
CC BY
© The Author(s). 2016
【 预 览 】
Files | Size | Format | View |
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RO202311095597458ZK.pdf | 566KB | download |
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