Abiotrophia defectivaを起因菌とした感染性心内膜炎で3弁治療を要した1例

Surgery to Triple Valves for Active Infective Endocarditis Caused by Abiotrophia defectiva：Report of a Case

はじめに　Abiotrophia defective（以下，Abiotrophia）は口腔内常在菌であり，一般的な5％ヒツジ血液寒天培地では発育が困難である．Ruoffは血液培養陰性の心内膜炎の重要な原因である可能性があると述べており1），わが国でAbiotrophiaを起因菌として3弁以上に感染した感染性心内膜炎（IE）の報告は見当たらない．われわれはAbiotrophiaが起因菌と考えられるIEで大動脈弁，僧帽弁，三尖弁に治療介入を行った症例を経験したので報告する．

We experienced a case of infective endocarditis caused by Abiotrophia defectiva in which aortic, mitral, and tricuspid valve surgery was performed. Even if blood cultures are negative, it is important to treat patients with endocarditis considering the possibility that some organisms are difficult to detect via conventional blood culture. Embolism is a complication that should not be overlooked in cases of infective endocarditis, particularly those caused by Abiotrophia defectiva， which tends to cause embolism. As the patient had splenic and cerebral infarction preoperatively, early surgical intervention was performed to prevent further embolisms, and the patient’s postoperative course was excellent.