感染性心内膜炎合并蛛网膜下腔出血、硬膜下血肿及多发性脑脓肿。

Infectious endocarditis associated with subarachnoid hemorrhage, subdural hematoma and multiple brain abscesses.

作者信息

Yanagihara Chie, Wada Yuko, Nishimura Yo

机构信息

Department of Neurology, Nishi-Kobe Medical Center, Kobe.

出版信息

Intern Med. 2003 Dec;42(12):1244-7. doi: 10.2169/internalmedicine.42.1244.

DOI:10.2169/internalmedicine.42.1244

PMID:14714968

Abstract

Hemorrhagic stroke is a complication of infectious endocarditis (IE), and severe hemorrhage accompanies Staphylococcus aureus IE during early uncontrolled infection. However, subarachnoid hemorrhage (SAH) or subdural hematoma is rare. A case of S. aureus IE associated with SAH and subdural hematoma in the early stage is reported. A 54-year-old man with a history of mitral valve prolapse presented with fever. Two days after the onset, he fell into a confused state with convulsion and left hemiparesis. He became comatose and brain CT and MRI demonstrated SAH and subdural hematoma with severe right hemisphere swelling. Multiple brain abscesses were also observed. No septic aneurysm was detected by cerebral angiography.

摘要

出血性中风是感染性心内膜炎（IE）的一种并发症，在早期未得到控制的感染期间，严重出血伴随金黄色葡萄球菌性IE出现。然而，蛛网膜下腔出血（SAH）或硬膜下血肿较为罕见。本文报道了1例早期伴有SAH和硬膜下血肿的金黄色葡萄球菌性IE病例。一名有二尖瓣脱垂病史的54岁男性出现发热症状。发病两天后，他陷入意识模糊状态，伴有抽搐和左侧偏瘫。随后他陷入昏迷，脑部CT和MRI显示有SAH和硬膜下血肿，右侧大脑半球严重肿胀。还观察到多个脑脓肿。脑血管造影未检测到感染性动脉瘤。