Sexton Daniel J, Spelman Denis
Department of Medicine, Division of Infectious Diseases, Box 3605, Duke University Medical Center, Durham, NC 27710, USA.
Cardiol Clin. 2003 May;21(2):273-82, vii-viii. doi: 10.1016/s0733-8651(03)00031-6.
The most important complications of endocarditis are congestive heart failure, paravalvular abscess formation, and embolism, especially stroke. In addition, endocarditis may be complicated by septic arthritis, vertebral osteomyelitis, pericarditis, metastatic abscesses and an array of renal problems ranging from immune-complex glomerulonephritis to renal abscesses. Adverse reactions associated with medical treatment of endocarditis can also result in significant complications such as ototoxicity and nephrotoxicity, skin rashes, and serum sickness. This review focuses on the cardiac, embolic, neurologic and renal complications of endocarditis and discusses how these complications influence the clinical management of individual cases in daily practice.
心内膜炎最重要的并发症是充血性心力衰竭、瓣周脓肿形成和栓塞,尤其是中风。此外,心内膜炎可能并发化脓性关节炎、脊椎骨髓炎、心包炎、转移性脓肿以及一系列肾脏问题,从免疫复合物性肾小球肾炎到肾脓肿。与心内膜炎药物治疗相关的不良反应也可能导致严重并发症,如耳毒性和肾毒性、皮疹以及血清病。本综述重点关注心内膜炎的心脏、栓塞、神经和肾脏并发症,并讨论这些并发症如何在日常实践中影响个别病例的临床管理。