İsmail Necati Hakyemez, Bülent DURDU, Gülay OKAY, Sibel BÖLÜKÇÜ, Bilge GÜLTTEPE, Turan ASLAN

Streptococcus parasanguinis’in neden olduğu spondilodiskit ile ortaya çıkan infektif endokardit olgusu

Streptococcus parasanguinis, oral floranın doğal bir üyesidir. Fırsatçı patojen olup, düşük virülansı nedeniyle nadiren sistemik infeksiyonlara yol açar. Subakut infektif endokarditi olan hastalar, spondilodiskit gibi farklı klinik tablolar ile prezente olabilmektedir. Kuzey Irak’lı, 65 yaşında erkek hasta; yüksek ateş, kilo kaybı, bel ağrısı ve yürüyememe yakınmaları ile acil servisimize başvurdu. Veteriner hekim olan hastamızın üç yıl önce kolon kanseri nedeniyle cerrahi ve ışın tedavisi aldığı öğrenilmiştir. Manyetik rezonans görüntülemede; lomber 1-2 de spondilodiskit saptandı. Transtorasik ekokardiyografide aort kapağında vejetasyon tespit edildi. Kan kültürlerinde S. parasanguinis izole edildi. Sonuç olarak; mesleği veteriner hekimlik olan, öyküsünde kolon kanseri bulunan spondilodiskit kliniği ile başvuran hastamızda, infektif endokadit etkeni olarak S. parasanguinis izole edilmesi dikkat çekici bulunmuştur.

Infective endocarditis case due to streptococcus parasanguinis presented with spondylodiscitis

Streptococcus parasanguinis is a natural member of oral flora. It is an opportunistic pathogen, and rarely cause systemic infections due to it’s low virulence. Subacute infective endocarditis may present with various clinical manifestations (eg., spondylodiscitis). A sixty-five years old male patient from Northern Iraq has referred to our emergency service with high fever, weight loss, back pain and inability to walk. The patient was a veterinarian. He was operated three years ago for colonic carcinoma and irradiated. In magnetic resonance imaging, spondylodiscitis was detected localized in lumbar 1-2 region. Transthorasic echocardiography demonstrated aortic valve vegetation. S. parasanguinis was identified in the blood cultures. In conclusion; all in all, it’s remarkable to isolate S. parasanguinis as a causal agent of infective endocarditis in a patient who is a veterinarian with history of colonic carcinoma presented with clinical manifestation of spondylodiscitis.

Keywords:

Streptococcus parasanguinis, endocarditis, spondylodiscitis,

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