초록 열기/닫기 버튼
최근 기저질환을 가진 나이 많은 성인에서의 침습성 S. agalactiae 감염증의 보고가 늘어나고 있다. S. agalactiae 감염심내막염은 비교적 드물지만 중증의 감염증으로 전신적 색전증과 광범위한 판막파괴로 인한 심부전이 잘 동반되므로 판막치환수술이 필요한 경우가 많다. 저자들은 기저질환으로 당뇨병과 알코올 중독이 있는 환자에서 발생한 S. agalactiae 감염심내막염 2예를 경험하였기에 드문 증례로 생각되어 문헌고찰과 함께 보고하는 바이다.
The higher incidence of Streptococcus agalactiae infection in the newborns and pregnant women had been well recognized. The incidence of invasive S. agalactiae infection was recently increasing in both elderly adults and those with comorbid conditions such as diabetes mellitus, liver cirrhosis, malignancy, and abnormalities in immune responses. We report our experience with two diabetic middle-aged men who suffered from S. agalactiae infective endocarditis. Case 1) A 58-year-old man with diabetes mellitus and chronic alcoholism presented with fever and both lower legs weakness. An echocardiography showed two vegetations on the mitral valve. S. agalactiae was identified from blood cultures. He was treated with penicillin G and gentamicin, and he underwent mitral valve replacement surgery because of persistent fever and newly developed brain infarcts. One month later, an amputation of the left lower leg was performed for the embolic gangrene of left lower leg. Case 2) A 57-year-old diabetic man was admitted to our hospital because of fever and left shoulder pain. He had received the incision and drainage to treat left shoulder joint septic arthritis, but he had a continuous fever. On 5th day of admission, culture of pus from the left shoulder joint revealed S. agalactiae. An echocardiography showed a vegetation on the posterior mitral leaflet. He was treated with penicillin G and gentamicin. On 18th day of admission, a mitral valve replacement surgery was performed. He was discharged without recurrence.
키워드열기/닫기 버튼
Streptococcus agalactiae, Infective endocarditis, Cerebral embolism
