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Endocardite por Staphylococcus lugdunensis : a propósito de um caso clínico
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Resumo(s)
Staphylococcus lugdunensis é um Staphylococcus coagulase negativo, descrito a primei-ra vez em 1988 e responsável por um espetro alargado de doenças. Tem sido considera-do como causa rara mas destrutiva de endocardite infecciosa (EI), com potencial embó-lico, podendo ser tão virulento como o Staphylococcus aureus e estando associado a uma história natural de EI com progressão mais rápida, mais agressiva e com elevada taxa de mortalidade.
O caso exposto neste trabalho de EI por Staphylococcus lugdunensis é o primeiro des-crito em Portugal e também o primeiro de endocardite infecciosa aguda das válvulas esquerdas por este agente, após cirurgia cardiovalvular. O tratamento cirúrgico é neces-sário na grande maioria dos doentes com EI por este agente, sendo crucial a identifica-ção atempada dos doentes com elevado risco de mortalidade no sentido de alterar o cur-so da doença de forma a melhorar o prognóstico.
É essencial o reconhecimento por parte dos especialistas da gravidade e capacidade de destruição associados a este agente, porque apesar de todos os avanços e esforços ao nível médico e cirúrgico no tratamento de EI, esta continua a ser uma doença associada a um elevado risco de mortalidade.
Staphylococcus lugdunensis is a coagulase negative Staphylococcus, first described in 1988 and responsible for a broad spectrum of diseases. It has been considered as a rare but destructive cause of infective endocarditis, with potential to cause embolic events and can be as virulent as the Staphylococcus aureus, being associated to a natural histo-ry of infectious endocarditis with faster progression, more aggressive and with a higher mortality rate. The case presented in this work of infectious endocarditis by Staphylococcus lugdunen-sis was the first described in Portugal and also the first of acute infective endocarditis of the left valves by this agent, after cardio valvular surgery. The surgical treatment is nec-essary in the vast majority of patients with infectious endocarditis by this agent and it is very important to make a prompt identification of the patients with higher mortality risk to change the course of the disease in order to improve the prognosis. It is therefore essential that specialists recognize the severity and capacity of destruction caused by this agent because despite every medical and surgical efforts and improve-ments to the treatment of infective endocarditis, this disease is still associated to a high risk of mortality.
Staphylococcus lugdunensis is a coagulase negative Staphylococcus, first described in 1988 and responsible for a broad spectrum of diseases. It has been considered as a rare but destructive cause of infective endocarditis, with potential to cause embolic events and can be as virulent as the Staphylococcus aureus, being associated to a natural histo-ry of infectious endocarditis with faster progression, more aggressive and with a higher mortality rate. The case presented in this work of infectious endocarditis by Staphylococcus lugdunen-sis was the first described in Portugal and also the first of acute infective endocarditis of the left valves by this agent, after cardio valvular surgery. The surgical treatment is nec-essary in the vast majority of patients with infectious endocarditis by this agent and it is very important to make a prompt identification of the patients with higher mortality risk to change the course of the disease in order to improve the prognosis. It is therefore essential that specialists recognize the severity and capacity of destruction caused by this agent because despite every medical and surgical efforts and improve-ments to the treatment of infective endocarditis, this disease is still associated to a high risk of mortality.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2017
Palavras-chave
Staphylococcus lugdunensis Endocardite infeciosa Mortalidade Prognóstico