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[感染性心内膜炎合并脾脓肿及脑出血]

[Infective endocarditis with splenic abscess and cerebral hemorrhage].

作者信息

Yamauchi Masanobu, Imai K, Sasaki T

机构信息

Department of Cardiovascular Surgery, Shimane Prefectural Central Hospital, Izumo, Japan.

出版信息

Kyobu Geka. 2005 Jul;58(7):527-30.

Abstract

A 65-year-old man was admitted with ataxic gait and high fever. Brain magnetic resonance imaging (MRI) showed multiple cerebral hemorrhages and echocardiogram showed vegetations attached to the mitral valve and moderate mitral regurgitation. No microorganisms were identified by blood culture examination. Despite adequate treatment with antibiotics, large multiple splenic abscesses were detected by computed tomography (CT), the patient complained of fever and the value of CRP was increased again. We decided to first perform splenectomy, followed by mitral valve repair and maze operation. The pathology of the spleen showed findings consistent with large abscesses due to septic emboli. The postoperative course was uneventful.

摘要

一名65岁男性因共济失调步态和高热入院。脑部磁共振成像(MRI)显示多处脑出血,超声心动图显示二尖瓣有赘生物附着且二尖瓣中度反流。血培养检查未发现微生物。尽管使用抗生素进行了充分治疗,但计算机断层扫描(CT)仍检测到多个巨大脾脓肿,患者仍有发热,且C反应蛋白值再次升高。我们决定先进行脾切除术,然后进行二尖瓣修复和迷宫手术。脾脏病理显示符合脓毒性栓子所致巨大脓肿的表现。术后过程顺利。

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