Pagès M, Lebourg O, Tannier C, Blard J M
Service de Neurologie A, CHU Gui de Chauliac, Montpellier.
Rev Neurol (Paris). 2001 Jan;157(1):55-61.
Fourteen cases of infective endocarditis revealed by neurological manifestations are reported: 8 strokes (one transient ischemic attack, one regressing and 6 completed strokes), 2 intracranial hematomas (one due to ruptured mycotic aneurysm), 2 toxic encephalopathies, one grand mal seizure, one suppurative meningitis. Most of them were native valve endocarditis, and streptococcus was the most frequently responsible bacteria. The outcome was characterized by a high mortality (6 cases) and morbidity (4 cases). This emphasizes the usefulness of preventing antibiotherapy in patients with known predisposing factors and the necessity for these patients to be admitted in neurological intensive care units.
报告了14例以神经症状为表现的感染性心内膜炎:8例中风(1例短暂性脑缺血发作、1例好转和6例完全性中风)、2例颅内血肿(1例因霉菌性动脉瘤破裂)、2例中毒性脑病、1例癫痫大发作、1例化脓性脑膜炎。其中大多数为自体瓣膜心内膜炎,最常见的致病菌是链球菌。结果显示死亡率高(6例)和发病率高(4例)。这强调了对有已知易感因素的患者进行预防性抗生素治疗的有效性,以及这些患者入住神经重症监护病房的必要性。