STAPHYLOCOCCUS LUGDUNENSIS’E BAĞLI DESTRÜKTİF SAĞ KAPAK ENDOKARDİTİ

Abstract

Koagülaz negatif stafilokok (KNS) grubunun bir üyesi olan Staphylococcus lugdunensis, normal cilt florası olarak insanların %30 ila %50'sinde çoğunlukla kasık bölgesi, koltuk altı ve burun deliklerinde olmak üzere kolonize olur. Patojen olarak ilk tanımlandığı 1988 yılından bu yana, giderek artan sayıda ve geniş bir yelpazede bulaşıcı hastalıkların bir nedeni olarak rapor edilmiştir. Bunlar yumuşak doku, kemik, eklem, idrar yolu enfeksiyonları ve çoğunlukla doğal sol kalp kapakçıklarını tutan, apse oluşumu, hızlı kapak yıkımı, yüksek emboli oranı ve çoğu durumda kapak değiştirme operasyonu gerekliliği ile karakterize agresif bir enfektif endokardit (EE) formu olarak klinikte karşımıza çıkar. Bu çalışmada kronik böbrek yetmezliği öyküsü olan bir erkek hastada hem triküspit hem de pulmoner kalp kapakçıklarını tutan S. lugdunensis'e bağlı şiddetli destrüktif EE olgusu sunulmaktadır. Hastada daptomisin artı klindamisin tedavisinin 42. gününde kapak replasmanı operasyonuna ihtiyaç duyulmuş ve ilk tanısından 58 gün sonra şifa ile taburcu edilmiştir.

Keywords

• enfektif endokardit
• Staphylococcus lugdunensis
• triküspit ve pulmoner kalp kapakçıkları

Destructive Right Valve Endocarditis due to Staphylococcus lugdunensis

Abstract

Staphylococcus lugdunensis, a member of the coagulase-negative staphylococci (CNS) group, colonizes as normal skin flora in 30% to 50% of people, mostly in the groin area, axillae and nostrils. Since 1988, when it was first identified as a pathogen, it has been reported as a cause of an increasing number and wide range of infections such as soft tissue, bone, joint, urinary tract infections, and an aggressive form of infective endocarditis (IE), mostly involving the native left heart valves, characterized by abscess formation, rapid valve destruction, high embolism rate and in most of the cases, the necessity of valve replacement operation. In this study, a case of severe destructive IE due to S.lugdunensis involving both tricuspid and pulmonary heart valves in a male patient with a history of chronic renal failure is presented. A valve replacement operation is needed on the 42nd day of daptomycin plus clindamycin treatment, and the patient was discharged with healing 58 days after diagnosis.

Keywords

• infective endocarditis
• Staphylococcus lugdunensis
• tricuspid and pulmonary heart valves

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