Cheung Y F, Leung M P, Yuen K Y
Division of Paediatric Cardiology, Department of Paediatrics, Grantham Hospital, The University of Hong Kong, Aberdeen, Hong Kong, PRC.
J Infect. 2001 Apr;42(3):206-7. doi: 10.1053/jinf.2001.0821.
A 20-year-old young man suffered from severe protein-losing enteropathy 4 years after Fontan operation. His postoperative haemodynamics were unfavourable in terms of poor myocardial contractility and moderate atrioventricular prosthetic paravalvar leakage. A 2-week trial of steroid therapy for protein-losing enteropathy was given without success. The clinical course was complicated by Legionella pneumophila pneumonia and bacteraemia, which respond to the combination therapy with intravenous erythromycin and ciprofloxacin. The vulnerability of the patient to infection was related to an immuno-deficiency state secondary to protein-losing enteropathy and steroid therapy. Steroids should be used with caution in the management of protein-losing enteropathy after Fontan operation.
一名20岁的年轻男性在Fontan手术后4年患上了严重的蛋白丢失性肠病。他术后的血流动力学状况不佳，心肌收缩力差，且存在中度房室人工瓣膜瓣周漏。针对蛋白丢失性肠病进行了为期2周的类固醇治疗试验，但未成功。临床过程中并发了嗜肺军团菌肺炎和菌血症，静脉注射红霉素和环丙沙星联合治疗有效。患者易感染与蛋白丢失性肠病和类固醇治疗继发的免疫缺陷状态有关。在Fontan手术后蛋白丢失性肠病的管理中，应谨慎使用类固醇。
