Clare Sarbjit, Ahmed Tariq, Singh Rohit, Gough Stephen
City Hospital, Acute Medicine, Birmingham, UK.
BMJ Case Rep. 2010 May 6;2010:bcr11.2009.2459. doi: 10.1136/bcr.11.2009.2459.
We present a rare case of endocarditis in a 33-year-old woman with a splenectomy. The patient presented with meningeal symptoms and was diagnosed with endocarditis on the medical admissions unit using a portable echocardiography machine. Bordetella holmesii was cultured from the blood on admission and the patient underwent subsequent aortic valve replacement. We discuss the importance of echo skills within the specialty of acute medicine and the benefits of swift senior review at the front door. We emphasise the guidelines on antibiotic prophylaxis for the post-splenectomy patient as well as discuss the pathogen B holmesii and its growing association of septicaemia in asplenic individuals.
我们报告一例33岁行脾切除术女性患心内膜炎的罕见病例。该患者出现脑膜症状，在医疗入院病房使用便携式超声心动图机被诊断为心内膜炎。入院时血培养出霍氏鲍特菌，患者随后接受了主动脉瓣置换术。我们讨论了急性医学专业中超声技能的重要性以及在前门进行快速高级评估的益处。我们强调了脾切除术后患者抗生素预防的指南，并讨论了病原体霍氏鲍特菌及其在无脾个体中与败血症日益增加的关联。
