JACC. Case reports · 2025
Culture-Negative Subacute Lactobacillus Endocarditis Diagnosed by Microbial Cell-Free DNA Sequencing.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Adi Abduljabar, Lebrun Sandrine, Kondo Maiko, Alvarez Villela Miguel, Fontes Joao Daniel
Аннотация
BACKGROUND: Lactobacillus endocarditis is a rare infection generally occurring in patients with heart disease and immunosuppression. Although Lactobacillus is typically a benign part of the gastrointestinal and genitourinary flora, it can cause invasive infections.
CASE SUMMARY: We present a case of a 74-year-old patient with low-grade fever and a nonproductive cough following recent cardiac surgery. Transesophageal echocardiography revealed vegetations, suggestive of endocarditis, despite negative blood cultures. Due to high suspicion for endocarditis, advanced genetic testing identified Lactobacillus fermentum as the causative pathogen. The patient disclosed daily probiotic use, likely the infection source. Treatment with intravenous ampicillin resulted in significant symptom improvement.
DISCUSSION: This case underscores the importance of considering probiotics as a potential source of bacteremia in patients with negative cultures after surgery and highlights how metagenomic sequencing can identify pathogens and guide effective therapy in challenging cases.
CASE SUMMARY: We present a case of a 74-year-old patient with low-grade fever and a nonproductive cough following recent cardiac surgery. Transesophageal echocardiography revealed vegetations, suggestive of endocarditis, despite negative blood cultures. Due to high suspicion for endocarditis, advanced genetic testing identified Lactobacillus fermentum as the causative pathogen. The patient disclosed daily probiotic use, likely the infection source. Treatment with intravenous ampicillin resulted in significant symptom improvement.
DISCUSSION: This case underscores the importance of considering probiotics as a potential source of bacteremia in patients with negative cultures after surgery and highlights how metagenomic sequencing can identify pathogens and guide effective therapy in challenging cases.