由耐青霉素的血链球菌引起的原发性三尖瓣心内膜炎。
Native triple-valve endocarditis caused by penicillin-resistant Streptococcus sanguis.
作者信息
Bavunoglu Isil, Sahin Serap, Yilmaz Mesut, Toptas Tayfur, Tabak Fehmi, Tunckale Aydin
机构信息
Department of Internal Medicine, Cerrahpasa Medical Faculty, University of Istanbul, Istanbul, Turkey.
出版信息
Nat Clin Pract Cardiovasc Med. 2007 Jun;4(6):340-3. doi: 10.1038/ncpcardio0906.
BACKGROUND
A 26-year-old man with known but untreated ventricular septal defect was admitted to the emergency ward with abdominal pain, fever and weight loss. Transthoracic echocardiography showed multiple vegetations on the anterior mitral leaflet, a mobile vegetation on the surface of the aortic noncoronary cusp and another on the tricuspid valve. His blood cultures grew Streptococcus sanguis with a penicillin minimum inhibitory concentration of 3 microg/ml.
INVESTIGATIONS
Physical examination, echocardiography, blood cultures, minimal inhibitory concentration detection.
DIAGNOSIS
Multivalvular infective endocarditis caused by S. sanguis with a high penicillin resistance.
MANAGEMENT
A combination of intravenous vancomycin and gentamicin, followed by early surgery.
背景
一名26岁男性，已知患有室间隔缺损但未治疗，因腹痛、发热和体重减轻入住急诊病房。经胸超声心动图显示二尖瓣前叶有多个赘生物，主动脉无冠瓣表面有一个可移动的赘生物，三尖瓣上也有一个。他的血培养结果为血链球菌生长，青霉素最低抑菌浓度为3微克/毫升。
检查
体格检查、超声心动图、血培养、最低抑菌浓度检测。
诊断
血链球菌引起的多瓣膜感染性心内膜炎，对青霉素耐药性高。
治疗
静脉注射万古霉素和庆大霉素联合治疗，随后尽早进行手术。
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