Giusti de Marle M, Sgreccia A, Carmenini E, Morelli S
Department of Internal Medicine, Università La Sapienza, Viale del Policlinico 155, 00161 Rome, Italy.
Postgrad Med J. 2004 Oct;80(948):619-20. doi: 10.1136/pgmj.2004.019711.
A case of infective endocarditis from Enterococcus faecalis after colonoscopy in a patient with aortic stenoinsufficiency and bleeding intestinal angiodysplasia (Heyde's syndrome) is reported.A 77 year old man with aortic stenoinsufficiency presented with enterorrhagia and underwent a colonoscopy, which showed normal findings. Fifteen days later he developed a moderate degree of fever. Blood cultures were positive for E faecalis. An echocardiogram showed aortic valve vegetations, and infective endocarditis was diagnosed and successfully treated by antibiotics. Some months later, intestinal bleeding recurred and intestinal resection was performed. Histopathology showed angiodysplasia. In patients with Heyde's syndrome antibiotic prophylaxis should be considered before colonoscopy.
报告了一例患有主动脉瓣狭窄关闭不全和肠道血管发育异常出血（海登氏综合征）的患者在结肠镜检查后发生粪肠球菌感染性心内膜炎的病例。一名患有主动脉瓣狭窄关闭不全的77岁男性出现肠出血并接受了结肠镜检查，检查结果正常。15天后，他出现中度发热。血培养显示粪肠球菌阳性。超声心动图显示主动脉瓣赘生物，诊断为感染性心内膜炎，并通过抗生素成功治疗。几个月后，肠道出血复发，进行了肠切除术。组织病理学显示血管发育异常。对于海登氏综合征患者，结肠镜检查前应考虑预防性使用抗生素。
