Aeromonas Endocarditis in an Intravenous Drug User Patient with Human Immunodeficiency Virus and Hepatitis C Virus Co-infection: A Case Report

產氣單胞桿菌引起人類免疫缺陷病毒和C型肝炎病毒共同感染的靜脈注射毒品使用者感染性心內膜炎：一病例報告及文獻回顧

洪東衛(Tung-Wei Hung) ； 李原地(Yuan-Ti Lee) ； 莊銘隆(Ming-Lung Chuang) ； 陳耿彬(Geng-Bin Chen) ； 楊凱凡(Kai-Fuan Yeo) ； 陳國勳(Kuo-Shuen Chen)

《中華民國急救加護醫學會雜誌》 23卷4期 (2012/12) Pp. 144-151

https://doi.org/10.30018/JECCM.201212.0003

摘要

我們報告一個39歲的台灣男性，是靜脈注射毒品使用者與人類免疫缺陷病毒和C型肝炎病毒共同感染有7年病史的患者，不曾有機會性感染，並已接受高效能抗反轉錄病毒療法兩個月了。他表現黃疸，疲勞，發燒，胸部X光檢查顯示雙側浸潤和急性肺水腫。經胸心臟超音波顯示三尖瓣贅生物，懷疑感染性心內膜炎。由兩套血液培養出產氣單胞桿菌，確診感染性心內膜炎。病人接受經靜脈meropenem治療。最後因為多形性心室性心律不整死亡。此病例提供我們在人類免疫缺陷病毒和C型肝炎病毒共同感染的靜脈注射毒品使用者，不常見的產氣單胞桿菌感染性心內膜炎在臨床上以敗血症表現。

關鍵字

產氣單胞桿菌 ； 感染性心內膜炎 ； 人類免疫缺陷病毒 ； 慢性C型肝炎

並列摘要

Introduction: We report on a 39-year-old Taiwan male, who was an intravenous drug user with human immunodeficiency virus and hepatitis C virus co-infection for 7 years, did not harbor any opportunistic infections, and had been receiving Highly Active Anti-retroviral Therapy for two months; and he suffering from jaundice, fatigue and fever for two months. Chest radiography revealed bilateral infiltration and acute pulmonary edema. Transthoracic echocardiography revealed a vegetation located on the tricuspid leaflets, suspected infective endocarditis. The diagnosis was confirmed of infective endocarditis by detecting Aeromona hydrophila in two sets of blood cultures. He received initially intravenous meropenem empiric treatment. An unexpected death occurred because of cardiac arrhythmia with polymorphic ventricular tachycardia.Conclusion: The case suggests that infective endocarditis should be considered as presenting with sepsis related to cardiac involvement relevant to unusual microorganisms, Aeromona hydrophila, infection in individuals of HIV-infected, chronic liver diseases, or intravenous user.

並列關鍵字

infective endocarditis ； intravenous drug user ； human immunodeficiency virus ； hepatitis C ； Aeromona hydrophila