RESUMO
Cardiobacterium hominis est un bacille à Gram négatif responsable d'endocardites infectieuses, principalement chez les patients atteints de pathologies cardiaques ou porteurs de valves. L'identification de cette bactérie est souvent complexe et peut être la cause d'un diagnostic et d'une prise en charge tardifs, source de complications cardiaques. Cet article présente la prise en charge d'une endocardite infectieuse associée à un sepsis à Cardiobacterium hominis, les difficultés d'identification de cette bactérie, ainsi qu'une revue de la littérature sur les infections dues à cette bactérie.
Assuntos
Cardiobacterium/isolamento & purificação , Endocardite Bacteriana/diagnóstico , Violeta Genciana , Infecções por Bactérias Gram-Negativas/diagnóstico , Técnicas Microbiológicas/métodos , Fenazinas , Cardiobacterium/crescimento & desenvolvimento , Diagnóstico Diferencial , Endocardite Bacteriana/microbiologia , Endocardite Bacteriana/terapia , Feminino , Violeta Genciana/química , Infecções por Bactérias Gram-Negativas/microbiologia , Infecções por Bactérias Gram-Negativas/terapia , Humanos , Técnicas Microbiológicas/normas , Pessoa de Meia-Idade , Fenazinas/química , Tempo para o TratamentoRESUMO
A polymerase chain reaction with an injection of the amplicons in an electrospray ionization mass spectrometry (PCR-ESI-MS) technique was evaluated for the diagnosis of bacterial and yeast pathogens on 13 cardiac valves with suspected endocarditis. At the moment of surgery, 3/13 PCR-ESI-MS results matched with microbiological documentation. Nine PCR-ESI-MS results correlated with Duke's criteria, leukocytes, C-reactive protein and blood cultures before surgery. The PCR-ESI-MS result of the last valve failed to confirm the blood culture result obtained fifteen days before. With speed and accuracy, this method may be useful to assert microbiological identification and adapt treatment.
Assuntos
Endocardite Bacteriana/diagnóstico , Valvas Cardíacas/microbiologia , Espectrometria de Massas por Ionização por Electrospray/métodos , Proteína C-Reativa/análise , Candida/crescimento & desenvolvimento , Candida/isolamento & purificação , Cardiobacterium/crescimento & desenvolvimento , Cardiobacterium/isolamento & purificação , DNA Bacteriano/isolamento & purificação , Endocardite Bacteriana/microbiologia , Feminino , Humanos , Masculino , Projetos Piloto , Reação em Cadeia da Polimerase/métodos , Propionibacterium acnes/crescimento & desenvolvimento , Propionibacterium acnes/isolamento & purificação , Staphylococcus aureus/crescimento & desenvolvimento , Staphylococcus aureus/isolamento & purificação , Staphylococcus lugdunensis/crescimento & desenvolvimento , Staphylococcus lugdunensis/isolamento & purificaçãoRESUMO
We report a case of prosthetic valve endocarditis caused by Cardiobacterium hominis in a patient who had undergone atrial septal defect closure and mitral valve replacement of the heart in 1978. He presented with pyrexia of unknown origin and congestive cardiac failure. Investigations revealed infective endocarditis of prosthetic valve in mitral portion. Blood culture samples grew C. hominis. The patient was empirically started on vancomycin and gentamicin intravenously and ceftriaxone was added after isolation of the organism. Though subsequent blood cultures were negative, patient remained in congestive cardiac failure and died due to complications.