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首页> 外文期刊>Cardiology Research >Escherichia coli Endocarditis Presenting With Septic Shock in an Immunocompetent Female Patient
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Escherichia coli Endocarditis Presenting With Septic Shock in an Immunocompetent Female Patient

机译：大肠杆菌的心脏心肌炎在免疫活性女性患者中呈现出脓毒症休克

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Escherichia coli (E. coli) is a rare cause of infective endocarditis, despite being a common cause of bacteremia. E. coli endocarditis affects most frequently immunocompromised elderly women, especially those with diabetes mellitus. We present a case of a 78-year-old female immunocompetent patient, presenting with septic shock and multiple organ dysfunction syndrome. E. coli was isolated in all sets of blood cultures and in urine culture and a contrast-enhanced abdominal computed tomography (CT) scan revealed spleen and left kidney infracts. Transthoracic echocardiography revealed a large ( 15 mm) mobile mass on the atrial side of the posterior mitral valve leaflet. The patient was initially treated with intravenous ceftriaxone and ciprofloxacin for 2 weeks with successful clinical response and clearance of bacteremia, was then subjected to valve replacement (with isolation of E. coli from replaced valve cultures) and continued antibiotic therapy for additional 4 weeks postoperatively. E. coli has emerged in recent years as an important cause of bacteremia, especially in the elderly. In selected patients, as those with persistent Gram-negative bacteremia or severe sepsis/septic shock, echocardiography is of paramount importance for the diagnosis of Gram-negative endocarditis and should be included in our diagnostic algorithm of patient's evaluation.Copyright 2019, Davoulos et al.
机译：大肠杆菌（大肠杆菌）是感染性心内膜炎的罕见原因，尽管是菌血症的常见原因。大肠杆菌心内膜炎影响最常见的免疫功能性的老年妇女，特别是患有糖尿病的老年人。我们提出了一个78岁女性免疫活性患者的案例，呈现出脓肌休克和多器官功能障碍综合征。大肠杆菌在所有血液培养物中和尿培养和尿培养和腹部计算断层扫描（CT）扫描中均出现脾脏，显示出脾脏和留下肾脏血液。经脉冲超声心动图在后部二尖瓣传单的心房侧显示出大（> 15毫米）的移动质量。患者最初用静脉内头孢菌和环丙沙星治疗2周，患有成功的临床反应和菌血症的间隙，然后进行瓣膜置换（分离从更换阀门培养物中的大肠杆菌），并术后4周持续抗生素治疗。近年来，大肠杆菌作为菌血症的重要原因，特别是在老年人。在选定的患者中，作为持续革兰阴性菌血症或严重脓毒症/脓肌休克的患者，超声心动图对于革兰氏阴性内膜炎的诊断至关重要，并且应包括在我们的患者评估诊断算法中。2019年，Davoulos等。

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