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人感染猪链球菌心内膜炎:超声心动图特征及临床结局

Human Streptococcus suis Endocarditis: Echocardiographic Features and Clinical Outcome.

作者信息

Pachirat Orathai, Taksinachanekit Suthep, Mootsikapun Piroon, Kerdsin Anusak

机构信息

Division of Cardiovascular Medicine.

出版信息

Clin Med Insights Cardiol. 2012;6:119-23. doi: 10.4137/CMC.S9793. Epub 2012 Jul 26.

Abstract

BACKGROUND

Human Streptococcus suis endocarditis occurs infrequently and continues to be a serious illness with high mortality. However, knowledge of the echocardiographic features and clinical outcome of this disease remains unclear.

METHODS

One hundred and fourteen patients were identified in a prospective study, and hospitalized at Queen Sirikit Heart Center and Srinagarind Hospital, Khon Kaen University. Echocardiography was routinely performed in all patients.

RESULTS

Between January 2010 and December 2011, three cases of S. suis endocarditis were diagnosed. All cases were male and aged 27-53 years. The most common risk factor for contracting S. suis infection was eating undercooked pork. Three patients presented with congestive heart failure. Transthoracic echocardiography demonstrated large, highly mobile vegetations and severe valvular damage. Aortic valve involvement was documented in two patients, and mitral valve involvement in one. One patient presented with embolic stroke and one with arterial occlusion. All patients underwent urgent valve replacement with a good clinical outcome.

CONCLUSION

The echocardiographic features of S. suis endocarditis show destructive, extensive valvular damage and early embolization with a fulminant course, needing early surgical intervention with a good clinical outcome.

摘要

背景

人感染猪链球菌性心内膜炎较为罕见,但仍是一种死亡率很高的严重疾病。然而,关于这种疾病的超声心动图特征和临床结局的认识仍不明确。

方法

在一项前瞻性研究中确定了114例患者,他们在呵叻府孔敬大学诗丽吉王后心脏中心和清拉琳医院住院。所有患者均常规进行了超声心动图检查。

结果

在2010年1月至2011年12月期间,诊断出3例猪链球菌性心内膜炎。所有病例均为男性,年龄在27至53岁之间。感染猪链球菌最常见的危险因素是食用未煮熟的猪肉。3例患者出现充血性心力衰竭。经胸超声心动图显示有大的、高度活动的赘生物和严重的瓣膜损害。2例患者有主动脉瓣受累,1例有二尖瓣受累。1例患者出现栓塞性中风,1例出现动脉闭塞。所有患者均接受了紧急瓣膜置换术,临床结局良好。

结论

猪链球菌性心内膜炎的超声心动图特征显示瓣膜有破坏性、广泛性损害,并早期发生栓塞,病程凶险,需要早期手术干预,临床结局良好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/03a1/3411327/ef2ae50e786f/cmc-6-2012-119f1.jpg

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