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[一名外科重症监护患者发生的脓肿形成和坏死性曲霉性心肌炎——罕见病例]

[Abscess-forming and necrotizing aspergillus myocarditis in a surgical intensive care patient--a rare occurrence].

作者信息

Fösel Th, Gauer I C, Eisenmann G, Mauser M

机构信息

Klinik für Anästhesiologie und operative Intensivmedizin, Klinikum Lahr/Schwarzwald, Lahr.

出版信息

Anasthesiol Intensivmed Notfallmed Schmerzther. 2003 Aug;38(8):538-41. doi: 10.1055/s-2003-41186.

Abstract

The case of an 89 year old patient is reported, in whom an aspergillus myocarditis was unexpectedly found at autopsy. Preoperatively, the patient showed no risk factors for an invasive mycosis. 5 days after uncomplicated surgery he developed septic shock due to peritonitis. After surgery and intensive care therapy the patient recovered initially. 23 days after the first operation the patient suddenly developed catecholamin-resistant myocardial failure and died. Ten days before, aspergillus spec. was found in a specimen of bronchial secretion. This finding was interpreted as colonisation and not treated.

摘要

报告了一名89岁患者的病例,该患者在尸检时意外发现患有曲霉性心肌炎。术前,患者没有侵袭性真菌病的危险因素。在进行了无并发症的手术后5天,他因腹膜炎发展为感染性休克。经过手术和重症监护治疗,患者最初有所恢复。首次手术后23天,患者突然出现对儿茶酚胺耐药的心肌衰竭并死亡。在这之前10天,在一份支气管分泌物标本中发现了曲霉属真菌。这一发现被解释为定植,未进行治疗。

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