Sexauer W P, Quezado Z, Lippmann M L, Goldberg S K
Pulmonary Section, Temple University School of Medicine, Philadelphia, Pa.
South Med J. 1992 Dec;85(12):1176-80. doi: 10.1097/00007611-199212000-00006.
The incidence, characteristics, and pathogenesis of pleural effusions in patients with right-sided endocarditis (RSE) are poorly defined. We have recently observed four patients with a history of intravenous drug abuse and bacteremia due to Staphylococcus aureus who had pleural effusions during an episode of RSE. We report the pleural fluid characteristics of five effusions in these four patients and attempt to define the pathogenesis of each. We found that (1) an exudative, sterile, serosanguineous, or bloody effusion is common in RSE, (2) empyema occurred in only one patient, and (3) transudative effusions due to CHF were not observed. Possible mechanisms of pleural fluid formation in RSE include parapneumonic effusion, septic pulmonary emboli with or without infarction, and empyema. Congestive heart failure does not appear to be a common cause of pleural effusion in pure right-sided endocarditis.
右侧心内膜炎（RSE）患者胸腔积液的发病率、特征及发病机制尚不清楚。我们最近观察了4例有静脉药物滥用史且因金黄色葡萄球菌导致菌血症的患者，他们在RSE发作期间出现了胸腔积液。我们报告了这4例患者中5例胸腔积液的特征，并试图确定每例的发病机制。我们发现：（1）渗出性、无菌性、浆液血性或血性胸腔积液在RSE中很常见；（2）仅1例患者发生脓胸；（3）未观察到因心力衰竭导致的漏出性胸腔积液。RSE中胸腔积液形成的可能机制包括肺炎旁胸腔积液、伴有或不伴有梗死的脓毒性肺栓塞以及脓胸。在单纯右侧心内膜炎中，充血性心力衰竭似乎不是胸腔积液的常见原因。
