Fradi Imen, Drissa Mohamed Akram, Cheour Mehdi, Drissa Habiba
Service de Cardiologie Adultes Hôpital La Rabra, Tunis, Tunisie.
Tunis Med. 2006 Oct;84(10):660-2.
Do we bring back the observation of a patient aged of 42 years having a mitro-aortic valvulopathy who present since 3 months a level III dyspnea, a fever to 39 degrees C, a change of the general state and a splenomegaly. To the chest x-ray we note a pulmonary parenchymatous focus. Echocardiography puts in evidence a mitral illness to stenosis predominance and an aortic illness complicated of a graft bacterial with an abscess of the mitro-aortic trigone. Haemocultures were negative and the serology of the Rickettsia was positive. The diagnosis of infective endocarditis to Coxiella Burnetii is kept and is the patient put under Doxycycline 200 mg/j, Hydroxychloroquine 2 cp/j and Ofloxacine 400 mg/j. Will the two first antibiotics be pursued to the 18th month. The patient benefited, after 20 days of three antibiotics therapy, of a duplicate aortic and mitral replacement with simple following.
我们是否回顾一下这位42岁患有二尖瓣主动脉瓣病变的患者的情况,他出现三级呼吸困难已有3个月,发热至39摄氏度,一般状况改变且脾肿大。胸部X光显示肺部实质有病灶。超声心动图显示以二尖瓣狭窄为主的病变以及主动脉病变合并细菌性移植物,伴有二尖瓣主动脉三角区脓肿。血培养阴性,立克次体血清学阳性。维持对伯氏考克斯体感染性心内膜炎的诊断,并给予患者强力霉素200毫克/天、羟氯喹2片/天和氧氟沙星400毫克/天。前两种抗生素是否持续使用到第18个月。在三种抗生素治疗20天后,患者接受了主动脉瓣和二尖瓣置换术,术后恢复顺利。