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Streptococcus parasanguinis’in neden olduğu spondilodiskit ile ortaya çıkan infektif endokardit olgusu

Yıl 2016, Cilt 41, Sayı 3, 595 - 600, 30.09.2016
https://doi.org/10.17826/cukmedj.237550

Öz

Streptococcus parasanguinis, oral floranın doğal bir üyesidir. Fırsatçı patojen olup, düşük virülansı nedeniyle nadiren sistemik infeksiyonlara yol açar. Subakut infektif endokarditi olan hastalar, spondilodiskit gibi farklı klinik tablolar ile prezente olabilmektedir. Kuzey Irak’lı, 65 yaşında erkek hasta; yüksek ateş, kilo kaybı, bel ağrısı ve yürüyememe yakınmaları ile acil servisimize başvurdu. Veteriner hekim olan hastamızın üç yıl önce kolon kanseri nedeniyle cerrahi ve ışın tedavisi aldığı öğrenilmiştir. Manyetik rezonans görüntülemede; lomber 1-2 de spondilodiskit saptandı. Transtorasik ekokardiyografide aort kapağında vejetasyon tespit edildi. Kan kültürlerinde S. parasanguinis izole edildi. Sonuç olarak; mesleği veteriner hekimlik olan, öyküsünde kolon kanseri bulunan spondilodiskit kliniği ile başvuran hastamızda, infektif endokadit etkeni olarak S. parasanguinis izole edilmesi dikkat çekici bulunmuştur.


Kaynakça

  • Toit MD, Huch M, Cho GS, Franz CM. The genus Streptococcus. In Lactic Acid Bacteria: Biodiversity and Taxonomy, 5th ed. (Eds WH Holzapfel, BJB Wood):457-505. 5th ed. New York, Wiley, 2014.
  • Geng J, Chiu CH, Tang P, Chen Y, Shieh HR, Hu S, et al. Complete genome and transcriptomes of Streptococcus parasanguinis FW213: phylogenic relations and potential virulence mechanisms. PLoS One. 2012;7:e34769.
  • Murillo O, Roset A, Sobrino B, Lora-Tamayo J, Verdaguer R, Jiménez-Mejias E et al. Streptococcal vertebral osteomyelitis: multiple faces of the same disease. Clin Microbiol Infect. 2014;20:O33-8.
  • Koslow M, Kuperstein R, Eshed I, Perelman M, Maor E, Sidi Y. The unique clinical features and outcome of infectious endocarditis and vertebral osteomyelitis co-infection. Am J Med. 2014;127:669 e9- e15.
  • Pigrau C, Almirante B, Flores X, Falco V, Rodríguez D, Gasser I et al. Spontaneous pyogenic vertebral osteomyelitis and endocarditis: incidence, risk factors, and outcome. Am J Med. 2005;118:1287.
  • Mulleman D, Philippe P, Senneville E, Costes C, Fages L, Deprez X et al. Streptococcal and enterococcal spondylodiscitis (vertebral osteomyelitis). High incidence of infective endocarditis in 50 cases. J Rheumatol. 2006;33:91-7.
  • Le Moal G, Roblot F, Paccalin M, Sosner P, Burucoa C, Roblot P et al. Clinical and laboratory characteristics of infective endocarditis when associated with spondylodiscitis. Eur J Clin Microbiol Infect Dis. 2002;21:671-5.
  • Ha SW, Shin JP, Kim SY, Park DH. Bilateral nongranulomatous uveitis with infective endocarditis. Korean J Ophthalmol. 2013;27:58-60.
  • De Rubens Figueroa J, Marhx A, López Terrazas J, Palacios Macedo A. Supravalvular aortic stenosis associated to infectious endocarditis and cerebral vascular disease in a patient with Williams-Beuren Syndrome. Arch Cardiol Mex. 2015;85:292-5.
  • López‐Pardo F, Aguilera A, Villa M, Granado C, Campos A, Cisneros JM. Double‐Chambered right ventricle associated with mural and pulmonic valve endocarditis: description of a clinical case and review of the literature. Echocardiography. 2004;21:171-3.
  • Fujitani S, Rowlinson MC, George WL. Penicillin Gresistant viridans group streptococcal endocarditis and interpretation of the American Heart Association's guidelines for the treatment of infective endocarditis. Clin Infect Dis. 2008;46:1064-6.
  • Park MR, Park DI, Yoo SJ, Jung SY, Eun HS, Kim MJ et al. Case of Pneumonia and parapneumonic effusion caused by Streptococcus parasanguinis. Tuberc Respir Dis. 2011;71:359-62.
  • Han XY, Kamana M, Rolston KV. Viridans streptococci isolated by culture from blood of cancer patients: clinical and microbiologic analysis of 50 cases. J Clin Microbiol. 2006;44:160-5.
  • Sadjadi SA, Ali H. Streptococcus parasanguis peritonitis: report of a case and review of the literature. Perit Dial Int. 2011;31:603-4.
  • Presterl E, Grisold AJ, Reichmann S, Hirschl AM, Georgopoulos A, Graninger W. Viridans streptococci in endocarditis and neutropenic sepsis: biofilm formation and effects of antibiotics. J Antimicrob Chemother. 2005;55:45-50.
  • Fernández-Garayzábal JF, Fernández E, Las Heras A, Pascual C, Collins MD, Domínguez L. Streptococcus parasanguinis: new pathogen associated with asymptomatic mastitis in sheep. Emerg Infect Dis. 1998;4:645-7.
  • Lee WS, Yu FL, Hsieh TC, Ou TY, Cheng FL, Jean SS. Streptococcus parasanguinis coinfection with Escherichia coli bacteremia in a patient with complicated urinary tract infection. J Exp Clin Med. 2014;6:230-1.
  • Baddour LM, Wilson WR, Bayer AS, Fowler VG, Tleyjeh IM, Rybak MJ et al. Infective endocarditis in adults: diagnosis, antimicrobial therapy, and management of complications. Circulation. 2015;132:1435-86.

Infective endocarditis case due to streptococcus parasanguinis presented with spondylodiscitis

Yıl 2016, Cilt 41, Sayı 3, 595 - 600, 30.09.2016
https://doi.org/10.17826/cukmedj.237550

Öz

Streptococcus parasanguinis is a natural member of oral flora. It is an opportunistic pathogen, and rarely cause systemic infections due to it’s low virulence. Subacute infective endocarditis may present with various clinical manifestations (eg., spondylodiscitis). A sixty-five years old male patient from Northern Iraq has referred to our emergency service with high fever, weight loss, back pain and inability to walk. The patient was a veterinarian. He was operated three years ago for colonic carcinoma and irradiated. In magnetic resonance imaging, spondylodiscitis was detected localized in lumbar 1-2 region. Transthorasic echocardiography demonstrated aortic valve vegetation. S. parasanguinis was identified in the blood cultures. In conclusion; all in all, it’s remarkable to isolate S. parasanguinis as a causal agent of infective endocarditis in a patient who is a veterinarian with history of colonic carcinoma presented with clinical manifestation of spondylodiscitis.


Kaynakça

  • Toit MD, Huch M, Cho GS, Franz CM. The genus Streptococcus. In Lactic Acid Bacteria: Biodiversity and Taxonomy, 5th ed. (Eds WH Holzapfel, BJB Wood):457-505. 5th ed. New York, Wiley, 2014.
  • Geng J, Chiu CH, Tang P, Chen Y, Shieh HR, Hu S, et al. Complete genome and transcriptomes of Streptococcus parasanguinis FW213: phylogenic relations and potential virulence mechanisms. PLoS One. 2012;7:e34769.
  • Murillo O, Roset A, Sobrino B, Lora-Tamayo J, Verdaguer R, Jiménez-Mejias E et al. Streptococcal vertebral osteomyelitis: multiple faces of the same disease. Clin Microbiol Infect. 2014;20:O33-8.
  • Koslow M, Kuperstein R, Eshed I, Perelman M, Maor E, Sidi Y. The unique clinical features and outcome of infectious endocarditis and vertebral osteomyelitis co-infection. Am J Med. 2014;127:669 e9- e15.
  • Pigrau C, Almirante B, Flores X, Falco V, Rodríguez D, Gasser I et al. Spontaneous pyogenic vertebral osteomyelitis and endocarditis: incidence, risk factors, and outcome. Am J Med. 2005;118:1287.
  • Mulleman D, Philippe P, Senneville E, Costes C, Fages L, Deprez X et al. Streptococcal and enterococcal spondylodiscitis (vertebral osteomyelitis). High incidence of infective endocarditis in 50 cases. J Rheumatol. 2006;33:91-7.
  • Le Moal G, Roblot F, Paccalin M, Sosner P, Burucoa C, Roblot P et al. Clinical and laboratory characteristics of infective endocarditis when associated with spondylodiscitis. Eur J Clin Microbiol Infect Dis. 2002;21:671-5.
  • Ha SW, Shin JP, Kim SY, Park DH. Bilateral nongranulomatous uveitis with infective endocarditis. Korean J Ophthalmol. 2013;27:58-60.
  • De Rubens Figueroa J, Marhx A, López Terrazas J, Palacios Macedo A. Supravalvular aortic stenosis associated to infectious endocarditis and cerebral vascular disease in a patient with Williams-Beuren Syndrome. Arch Cardiol Mex. 2015;85:292-5.
  • López‐Pardo F, Aguilera A, Villa M, Granado C, Campos A, Cisneros JM. Double‐Chambered right ventricle associated with mural and pulmonic valve endocarditis: description of a clinical case and review of the literature. Echocardiography. 2004;21:171-3.
  • Fujitani S, Rowlinson MC, George WL. Penicillin Gresistant viridans group streptococcal endocarditis and interpretation of the American Heart Association's guidelines for the treatment of infective endocarditis. Clin Infect Dis. 2008;46:1064-6.
  • Park MR, Park DI, Yoo SJ, Jung SY, Eun HS, Kim MJ et al. Case of Pneumonia and parapneumonic effusion caused by Streptococcus parasanguinis. Tuberc Respir Dis. 2011;71:359-62.
  • Han XY, Kamana M, Rolston KV. Viridans streptococci isolated by culture from blood of cancer patients: clinical and microbiologic analysis of 50 cases. J Clin Microbiol. 2006;44:160-5.
  • Sadjadi SA, Ali H. Streptococcus parasanguis peritonitis: report of a case and review of the literature. Perit Dial Int. 2011;31:603-4.
  • Presterl E, Grisold AJ, Reichmann S, Hirschl AM, Georgopoulos A, Graninger W. Viridans streptococci in endocarditis and neutropenic sepsis: biofilm formation and effects of antibiotics. J Antimicrob Chemother. 2005;55:45-50.
  • Fernández-Garayzábal JF, Fernández E, Las Heras A, Pascual C, Collins MD, Domínguez L. Streptococcus parasanguinis: new pathogen associated with asymptomatic mastitis in sheep. Emerg Infect Dis. 1998;4:645-7.
  • Lee WS, Yu FL, Hsieh TC, Ou TY, Cheng FL, Jean SS. Streptococcus parasanguinis coinfection with Escherichia coli bacteremia in a patient with complicated urinary tract infection. J Exp Clin Med. 2014;6:230-1.
  • Baddour LM, Wilson WR, Bayer AS, Fowler VG, Tleyjeh IM, Rybak MJ et al. Infective endocarditis in adults: diagnosis, antimicrobial therapy, and management of complications. Circulation. 2015;132:1435-86.

Kaynak Göster

MLA Hakyemez, İ. N. , Durdu, B. , Okay, G. , Bölükçü, S. , Gülttepe, B. , Aslan, T. "Streptococcus parasanguinis’in neden olduğu spondilodiskit ile ortaya çıkan infektif endokardit olgusu" . Cukurova Medical Journal 41 (2016 ): 595-600 <https://dergipark.org.tr/tr/pub/cumj/issue/18992/237550>