Masuoka Ayumu, Imanaka Kazuhito, Sugie Masamitsu, Ogiwara Masanori, Nishimura Motonobu, Kato Masaaki, Asano Haruhiko, Kuboi Koetsu, Yamada Yuichi, Nishimura Shigeyuki, Kyo Shunei
Department of Cardiovascular Surgery, Saitama Medical School.
J Cardiol. 2005 Dec;46(6):243-7.
A 75-year-old man was treated for 4 weeks with penicillin administration for infective endocarditis in the mitral valve caused by Enterococcus faecalis. The infection recurred, so he received penicillin administration for a further 6 weeks. He remained afebrile and all laboratory examinations were within normal limits for 6 weeks after the antibiotic treatment was discontinued, but the vegetation remained large and highly mobile. Since the onset, possible embolic episodes had occurred three times. He underwent mitral valve repair with annuloplasty. Although the infection appeared to have healed by antibiotic therapy, resected tissue was strongly positive for Enterococcus faecalis. This case suggests that surgery should be aggressively considered if the vegetation does not shrink markedly.
一名75岁男性因粪肠球菌引起的二尖瓣感染性心内膜炎接受了4周的青霉素治疗。感染复发，因此他又接受了6周的青霉素治疗。在抗生素治疗停止后的6周内，他一直未发热，所有实验室检查结果均在正常范围内，但赘生物仍然很大且活动度很高。自发病以来，已发生过三次可能的栓塞事件。他接受了二尖瓣成形术修复。尽管抗生素治疗后感染似乎已治愈，但切除的组织粪肠球菌检测呈强阳性。该病例表明，如果赘生物没有明显缩小，应积极考虑手术治疗。
