Hsu Ron-Bin, Chen Robert J, Chu Shu-Hsun
Department of Surgery, National Taiwan University Hospital and College of Medicine, No. 7 Chung-Shan S. Road, Taipei 100, Taiwan.
J Formos Med Assoc. 2004 May;103(5):355-8.
Infective endocarditis complicating liver cirrhosis is infrequently reported. This study evaluated the clinical features of infective endocarditis in Taiwanese patients with liver cirrhosis.
All cases of infective endocarditis occurring in patients with liver cirrhosis from December 1995 to December 2002 were included in this study. Data were collected by retrospective chart review.
Twenty six patients (18 males, 8 females) with median age 6 years (range, 43 to 87) were included. The etiology of liver cirrhosis was hepatitis virus infection in 20 patients. There were 7 nosocomial infections. Bacterial pathogens were identified in 25 patients, with Staphylococcus aureus (n = 8), viridans streptococci (n = 4), Streptococcus sanguis (n = 2), Pseudomonas aeruginosa (n = 2), and Enterococcus faecalis (n = 2) the most common isolates. The hospital mortality rate was 27%. Patients with in-hospital death were more likely to have a history of uremia, staphylococcal infection, nosocomial infection and less likely to have aortic valve infection.
The prognosis of patients with infective endocarditis and liver cirrhosis was poor. Infection with Staphylococcus species was a dominant cause and methicillin resistance was common.
感染性心内膜炎并发肝硬化的报道较少。本研究评估了台湾肝硬化患者感染性心内膜炎的临床特征。
本研究纳入了1995年12月至2002年12月期间发生在肝硬化患者中的所有感染性心内膜炎病例。通过回顾性病历审查收集数据。
纳入26例患者（18例男性，8例女性），中位年龄6岁（范围43至87岁）。20例肝硬化的病因是肝炎病毒感染。有7例医院感染。25例患者鉴定出细菌病原体，最常见的分离株为金黄色葡萄球菌（n = 8）、草绿色链球菌（n = 4）、血链球菌（n = 2）、铜绿假单胞菌（n = 2）和粪肠球菌（n = 2）。医院死亡率为27%。住院死亡患者更可能有尿毒症、葡萄球菌感染、医院感染史，且较少有主动脉瓣感染。
感染性心内膜炎和肝硬化患者的预后较差。葡萄球菌感染是主要原因，耐甲氧西林情况常见。
