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페렴구균 균혈증은 주로 만성적인 흡연, 최근의 호흡기계 감염, 만성 폐질환 등의 국소 기전의 장애가 있거나, 고령, 장기간 스테로이드 사용, 만성 질환 등으로 전신적 면역 반응에 장애가 있는 경우에 보고된다. 악성종양 자체가 그 소인으로 알려져 있지는 않지만, 저자들은 폐암 환자에게서 발생한 폐렴구균 균혈증, 그로 인한 세균성 심내막염 및 내인성 안구내염, 화농성 관절염을 진단하여 이에 대한 감수성 있는 항생제 사용 및 조기 수술적 치료를 통해 경과 호전을 경험하여 보고하는 바이다.


Pneumococcal endocarditis accompanied by pneumococcal bacteremia is a rare condition. However, its clinical course is typically aggressive and associated with high morbidity and mortality rates. We report a case of a 67-year-old male who had small cell lung cancer and was undergoing concurrent chemoradiation therapy, and who presented with pneumococcal bacteremia complicated by infective endocarditis, endogenous endophthalmitis, and septic arthritis of the wrist. He presented with fever, sudden blindness, and a systolic cardiac murmur. Blood cultures were positive for penicillin susceptible Streptococcus pneumoniae. Despite appropriate treatment with intravenous and intravitreal antibiotics, destructive changes still appeared in his vitreous, mitral, and aortic valves. He underwent a vitrectomy and mitral and aortic valve replacement. We were able to prevent further embolic events with antibiotics and early surgical management.