Staphylococcus haemolyticus心內膜炎：案例報告

Staphylococcus haemolyticus endocarditis: A Case Report

一位接受血液透析治療的90歲的男性尿毒症病人，於104年4月20日因為發燒而入院，分別在4月20日及4月24日送驗的四套血液培養結果均生長Staphylococcus haemolyticus，同時4月23日的心臟超音波檢查的結果顯示：在二尖瓣瓣膜存在一個約3.18cm×1.83cm大小的贅生物（vegetation）。因此，確定診斷為S. haemolyticus心內膜炎，雖然使用vancomycin治療，最後病患仍然死亡。在此，我們建議：一旦血液培養生長coagulase-negative staphylococci（CoNS），都應該鑑定到菌種的層次，如此能提供臨床醫師更容易判斷是真正菌血症或假性菌血症的依據。

A 90-year-old male patient with uremia received treatment with hemodialysis was admitted on 20 April 2014. All of four blood cultures taken on 20 and 24 April were positive with Staphylococcus haemolyticus. Heart echo performed on 23 April revealed a vegetation of 3.18 cm × 1.83 cm on mitral valve. Consequently, S. haemolyticus endocarditis was definitive diagnosis. Despite of treatment with vancomycin, the patient was still expired. Herein, we suggest that once blood culture is positive with coagulase-negative staphylococci (CoNS), it should be identified to species level. If so, which perhaps offer further discrimination to clinical clinicians to differentiate true bacteremia or pseudobacteremia.