Ishida Narihiro, Shimabukuro Katsuya, Matsuno Yukihiro, Higashi Toshiya, Takemura Hirofumi
Department of General and Cardiothoracic Surgery, Graduate School of Medicine, Gifu University, 1-1 Yanagido, Gifu City, Gifu, 501-1194, Japan,
Surg Today. 2014 Oct;44(10):1946-8. doi: 10.1007/s00595-013-0633-2. Epub 2013 Jun 7.
A 55-year-old male with an intermittent high-grade fever was diagnosed with infective endocarditis. He was indicated for surgery because periodic echocardiography revealed worsening mitral regurgitation and growing vegetation despite medication. An aneurysm of the P2 portion and all vegetations were removed via quadrangular resection of the P2 leaflet, and then the defect was repaired. An intraoperative assessment identified Staphylococcus lugdunensis as the causative bacterium. After postoperative antibiotic therapy for 5 weeks, the patient was discharged without either mitral regurgitation or signs of infection. Infective endocarditis caused by aggressive and destructive S. lugdunensis should be promptly and accurately treated via a surgical approach that prevents progressive tissue destruction and simplifies the surgical procedure for repair, rather than replacement.
一名55岁男性，间歇性高热，被诊断为感染性心内膜炎。尽管进行了药物治疗，但定期超声心动图显示二尖瓣反流恶化且赘生物增大，因此他被建议进行手术。通过P2瓣叶四边形切除术切除P2部分的动脉瘤和所有赘生物，然后修复缺损。术中评估确定病原菌为路邓葡萄球菌。术后进行了5周的抗生素治疗，患者出院时既无二尖瓣反流也无感染迹象。对于由侵袭性和破坏性的路邓葡萄球菌引起的感染性心内膜炎，应通过一种手术方法及时准确地进行治疗，这种方法可防止组织进行性破坏并简化修复手术程序，而不是进行置换。
