Sakata K, Misawa Y, Kato M, Take A, Takahashi T, Hasegawa T
Department of Thoracic and Cardiovascular Surgery, Jichi Medical School, Tochigi, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1992 Sep;40(9):1759-63.
A 13-year-old girl was admitted to a hospital because of fever and sore throat. Staphylococcus aureus was obtained on blood culture, and she was treated with antibiotics under the diagnosis of sepsis and DIC. Echocardiography showed huge vegetation attached to the posterior leaflet of mitral valve and severe mitral regurgitation. CT scan revealed multiple heterogeneous high density areas in her brain. She was transferred to our hospital for further examination and treatment. Large verrucae on the mitral valve, severe regurgitation and repeated embolism urged us to the emergency mitral valve replacement. Debridement of abscess on the posterior wall of the left atrium and ventricle necessitated patch plasty of those structures and mitral ring as well. Operative and postoperative examination showed mycotic aneurysm of right coronary artery, multiple brain hemorrhage, arterial obstructions of extremities and splenic infarction. Sooner she recovered except for slight macular degeneration caused by retinal embolism.
一名13岁女孩因发热和喉咙痛入院。血培养分离出金黄色葡萄球菌,她在败血症和弥散性血管内凝血的诊断下接受了抗生素治疗。超声心动图显示巨大赘生物附着于二尖瓣后叶,伴有严重二尖瓣反流。CT扫描显示她脑部有多个不均匀高密度区。她被转至我院进一步检查和治疗。二尖瓣上的巨大疣状赘生物、严重反流和反复栓塞促使我们进行急诊二尖瓣置换术。左心房和心室后壁脓肿的清创术需要对这些结构以及二尖瓣环进行补片修补。手术中和术后检查显示右冠状动脉霉菌性动脉瘤、多处脑出血、肢体动脉阻塞和脾梗死。除了视网膜栓塞导致的轻微黄斑变性外,她很快康复。