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文森巴尔通体致人类感染性心内膜炎1例报告并文献复习

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目的 探讨文森巴尔通体博格霍夫亚种(Bvb)所致感染性心内膜炎的临床特点及诊疗策略。方法 报告国内1例25岁男性感染Bvb导致心内膜炎患者的临床诊治经过,同时结合国外报道的3例相似案例文献资料进行总结分析。结果 4例患者均为青壮年男性,既往1年内有犬类动物密切接触史;以胸痛、疲乏、呼吸困难为主要症状,合并脑血管意外及严重贫血,有心脏瓣膜赘生物形成及瓣膜功能损伤;多次血培养阴性,2例经病原微生物宏基因组二代测序技术(mNGS),3例经聚合酶链反应明确为Bvb感染。患者均因心力衰竭接受手术治疗,经手术及针对性抗感染治疗后患者均存活。结论 本例报告为国内首例Bvb感染性心内膜炎病例。患者经血清学间接免疫荧光分析法(IFA)及NGS明确诊断,手术结合抗感染治疗效果理想。
Human infective endocarditis caused by Bartonella vinsonii subsp.berk-hoffii:one case report and literature review
Objective To explore the clinical characteristics and treatment strategies of infective endocarditis caused by Bartonella vinsonii subsp.berkhoffii(Bvb).Methods Clinical diagnosis and treatment of a 25-year-old male patient with infective endocarditis caused by Bvb in China was reported,combined with literatures about three similar cases reported abroad were summarized and analyzed.Results All 4 patients were young and middle-aged males with a history of close contact with canines in the past one year.The main symptoms were chest pain,fa-tigue,and dyspnea,accompanied by cerebrovascular accidents and severe anemia,as well as the formation of heart valve vegetations and valve function impairment.Multiple blood cultures were negative,2 and 3 cases were con-firmed to be infected with Bvb through metagenomic next-generation sequencing(mNGS)of pathogenic microorga-nisms and polymerase chain reaction respectively.All patients underwent surgical treatment due to heart failure,and all survived after surgery and targeted anti-infective treatment.Conclusion This case report is the first case of Bvb infective endocarditis in China.Patient's diagnosis is confirmed by serum indirect immunofluorescence assay and mNGS,combination of surgery and anti-infective treatment has achieved ideal effect.

infective endocarditisBartonellametagenomic next-generation sequencing technologynegative blood culture

闫俊彦、马瑞彦、肖颖彬、郝嘉、李明文、李建、陈林、蒋迎九

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重庆医科大学附属第一医院,重庆 400042

中国人民解放军陆军军医大学第二附属医院新桥医院,重庆 400037

感染性心内膜炎 巴尔通体 宏基因组学第二代测序技术 血培养阴性

重庆市科学技术局重点项目

CSTB2022TIAD-KPX0004

2024

中国感染控制杂志
中南大学

中国感染控制杂志

CSTPCD北大核心
影响因子:2.112
ISSN:1671-9638
年,卷(期):2024.23(10)