Doki Noriko, Matsushima Takafumi, Tsukamoto Norifumi, Nojima Yoshihisa, Karasawa Masamitsu, Murakami Hirokazu
Third Department of Internal Medicine, Gunma University, School of Medicine.
Rinsho Ketsueki. 2002 Sep;43(9):828-32.
We present here a patient with acute myeloid leukemia (M2) who developed fatal infective endocarditis. On admission, the patient (67-year-old male) had mitral stenosis and atrial fibrillation. Complete remission was achieved after induction chemotherapy. During the course of consolidation therapy, he developed sepsis caused by coagulase-negative staphylococcus, which was successfully treated with antibiotics. Thereafter, blood culture yielded multidrug-resistant staphylococcus epidermidis. An echocardiogram revealed mitral valve regurgitation with vegetation. He was diagnosed as having infectious endocarditis. In spite of prolonged antibiotic therapy, destruction of the mitral valve progressed, and the patient underwent valve replacement therapy. He died of cardiac tamponade 5 days after the surgery.
我们在此报告一名急性髓系白血病(M2型)患者,该患者并发了致命性感染性心内膜炎。入院时,患者(67岁男性)患有二尖瓣狭窄和心房颤动。诱导化疗后实现了完全缓解。在巩固治疗过程中,他发生了由凝固酶阴性葡萄球菌引起的败血症,经抗生素治疗成功。此后,血培养检出耐多药表皮葡萄球菌。超声心动图显示二尖瓣反流伴赘生物。他被诊断为感染性心内膜炎。尽管进行了长时间的抗生素治疗,二尖瓣的破坏仍在进展,患者接受了瓣膜置换治疗。术后5天,他死于心脏压塞。