Fukumitsu Kensuke, Suzuki Yujiro
Department of Respiratory Center, Shinko Hospital.
Kansenshogaku Zasshi. 2012 May;86(3):282-6. doi: 10.11150/kansenshogakuzasshi.86.282.
A 30-year-old woman was admitted to our hospital with high fever and chest pain. She had a ventricular septal defect, but was asymptomatic and had not undergone surgical repair. She also had had atopic dermatitis since childhood that had not been adequately treated. Chest computed tomography showed multiple peripheral nodules and infiltrates in both lungs. A transthoracic echocardiogram detected vegetation on the wall of the right ventricle, and Staphylococcus aureus was cultured from a peripheral blood sample. She was diagnosed as having a septic pulmonary embolism associated with right-sided infective endocarditis caused by S. aureus. She was treated with Cefazolin, resulting in gradual improvement of laboratory and chest radiographic findings. Recent studies have revealed that atopic dermatitis is one of the risk factors for infective endocarditis. In this case, uncontrolled atopic dermatitis might have caused the right-sided infective endocarditis.
一名30岁女性因高热和胸痛入院。她患有室间隔缺损,但无症状且未接受过手术修复。她自童年起就患有特应性皮炎,一直未得到充分治疗。胸部计算机断层扫描显示双肺有多个外周结节和浸润影。经胸超声心动图检测到右心室壁有赘生物,外周血样本培养出金黄色葡萄球菌。她被诊断为患有由金黄色葡萄球菌引起的右侧感染性心内膜炎相关的脓毒性肺栓塞。她接受了头孢唑林治疗,实验室检查结果和胸部影像学表现逐渐改善。最近的研究表明,特应性皮炎是感染性心内膜炎的危险因素之一。在这个病例中,未得到控制的特应性皮炎可能导致了右侧感染性心内膜炎。