Whatling Philip J, Robb J Daniel, Byrne Jonathan, Wendler Olaf
Department of Cardiothoracic Surgery, King's College Hospital, London, UK.
BMJ Case Rep. 2011 Aug 17;2011:bcr0320113949. doi: 10.1136/bcr.03.2011.3949.
Current guidance recommends against the use of antibiotic prophylaxis around the time of dental intervention for the prevention of infective endocarditis. The authors report the case of a previously well-patient with an asymptomatic isolated ventricular septal defect (VSD) who developed evidence of infective systemic and pulmonary emboli following dental treatment. A diagnosis of severe endocarditis of a previously normal native mitral valve was made. She subsequently underwent surgical repair of her mitral valve, and closure of her VSD. She was deemed fit for discharge on parenteral antibiotics on the thirtieth postoperative day. The authors highlight the need for further re-evaluation of the issues surrounding antibiotic prophylaxis for endocarditis in the context of dental procedures.
当前指南建议，在进行牙科干预时不使用抗生素预防措施来预防感染性心内膜炎。作者报告了一例既往健康的患者，该患者有无症状孤立性室间隔缺损（VSD），在接受牙科治疗后出现了感染性全身和肺栓塞的证据。诊断为先前正常的天然二尖瓣严重心内膜炎。她随后接受了二尖瓣手术修复及室间隔缺损闭合术。术后第30天，她被认为适合在接受肠外抗生素治疗的情况下出院。作者强调，需要在牙科手术的背景下，进一步重新评估围绕心内膜炎抗生素预防的相关问题。
