Staphylococcus Aureus Endocarditis in an Uremic Patient Undergoing Continuous Ambulatory Peritoneal Dialysis

金黃色葡萄球菌在連續性可動式腹膜透析病人造成心內膜炎

高皓璽(Hao-Hsi Kao) ； 陳國書(Kuo-Su Chen)

《內科學誌》 20卷3期 (2009/06) Pp. 264-269

https://doi.org/10.6314/JIMT.2009.20(3).11

摘要

金黃色葡萄球菌感染在血液透析病人是經常可見的問題，此種細菌易於造成轉移性感染，因而引發心內膜炎。然而金黃色葡萄球菌感染而造成心內膜炎在腹膜透析病人是相當少見的。本案例報告一個腹膜透析的病人，因金黃色葡萄球菌而造成敗血症，經過一系列的檢查，發現在二尖瓣後葉有贅生物。病人於發病前2個月曾有過一次金黃色葡萄球菌導致的腹膜炎。由此案例可知尿毒症的病人經由腹膜透析治療，當受到金黃色葡萄球菌感染，仍易於變成心內膜炎。臨床醫師應了解此一風險，當長時間且反覆性的菌血症發生時要積極的檢查是否為心內膜炎。

並列摘要

Staphylococcus aureus (S. aureus) infection is a frequently encountered problem in hemodialysispatients. As this organism is prone to develop metastatic infection, each episode of S. aureus bacteremia put the patients at risk of developing endocarditis. However, it is rarely reported in patients undergoing peritoneal dialysis although these patients were also susceptible to S. aureus infection. This report presents a case of endocarditis in an uremic patient undergoing chronic peritoneal dialysis therapy. This patient presented with S. aureus bacteremia of unknown focus, but she experienced an episode of S. aureus peritonitis just two months ago. This patient died of complications despite aggressive treatment with appropriate antibiotics. This experience indicates that uremic patients undergoing peritoneal dialysistherapy are also susceptible to developing endocarditis due to S. aureus infection. Clinicians should beaware of this risk. Aggressive investigation for endocarditis should be undertaken when the S. aureus bacteremia course is prolonged or recurrent in dialysis patients.

並列關鍵字

Staphylococcus aureus ； Endocarditis ； Peritonitis ； Hemodialysis ； Peritoneal dialysis