Nakayama Takayuki, Yokoyama Minato, Saito Kazutaka, Takenaka Shunsuke, Kubo Yuichi, Iimura Yasumasa, Numao Noboru, Sakai Yasuyuki, Koga Fumitaka, Fujii Yasuhisa, Kobayashi Tsuyoshi, Kawakami Satoru, Kihara Kazunori
The Department of Urology, Graduate School, Tokyo Medical and Dental University.
Nihon Hinyokika Gakkai Zasshi. 2009 Mar;100(3):504-7. doi: 10.5980/jpnjurol.100.504.
A 46-year-old woman with sudden on set strong right flank pain was transferred to our hospital with the diagnosis of right renal infarction. Cardiac ultrasonography revealed a vegetation on the posterior cusp of the mitral valve, and the renal infarction was thought to be caused by renal artery embolism from infective endocarditis. Since the vegetation remained after antimicrobial therapy as conservative management, the patient was surgically treated by mitral annuloplasty. It has been known that infective endocarditis can cause renal infarction. Infective endocarditis requires immediate and adequate treatment because of high mortality. Therefore, the appropriate diagnosis of infective endocarditis is needed for patients with renal infarction without any other disorder causing renal infarction.
一名46岁突发右侧剧烈腰痛的女性被转诊至我院,诊断为右肾梗死。心脏超声检查发现二尖瓣后叶有赘生物,考虑肾梗死是由感染性心内膜炎导致的肾动脉栓塞引起。由于抗菌治疗后赘生物仍存在,故采取保守治疗,患者接受了二尖瓣环成形术。已知感染性心内膜炎可导致肾梗死。由于感染性心内膜炎死亡率高,需要立即进行充分治疗。因此,对于没有其他导致肾梗死疾病的肾梗死患者,需要正确诊断感染性心内膜炎。