Maeno K, Hirota S, Kubota K, Takata S, Ikeda T, Kobayachi K, Fujita S, Matsubara F
First Department of Internal Medicine, School of Medicine, Kanazawa University.
Kokyu To Junkan. 1990 Jun;38(6):605-8.
We encountered a case of an 83-year-old patient with candida endocarditis. He had been diagnosed as having aortic regurgitation with moderately calcified aortic valve 5 years previously, and had received medication. He was admitted to our hospital because of pancreatic cancer. He had high fever from the time of his admission and antibiotics produced no effect. Candida albicans was detected in arterial blood culture. We also detected antibody against Candida albicans, and investigated serum mannan and the D-arabinitol creatinine ratio several times. We performed echo-cardiographic examination and recorded a vegetation at the aortic valve. Rising antibody titers against Candida albicans, mannan antigenemia and an elevated creatinine ratio were also observed. So we concluded that these examinations were also effective in the diagnosis of candida infection. Finally, this patient died of cerebral hemorrhage and was autopsied. Macroscopic findings showed mass-like vegetation involving the aortic valve, and microscopic findings showed candida organisms scattered within the vegetation.
我们遇到一例83岁的念珠菌性心内膜炎患者。他在5年前被诊断为主动脉瓣反流伴主动脉瓣中度钙化,并接受了药物治疗。他因胰腺癌入住我院。自入院起他就持续高热,使用抗生素无效。动脉血培养检测出白色念珠菌。我们还检测到了抗白色念珠菌抗体,并多次检测血清甘露聚糖和D-阿拉伯糖醇肌酐比值。我们进行了超声心动图检查,发现主动脉瓣有赘生物。同时还观察到抗白色念珠菌抗体滴度升高、甘露聚糖血症以及肌酐比值升高。因此我们得出结论,这些检查对念珠菌感染的诊断也有效。最后,该患者死于脑出血并进行了尸检。宏观检查发现主动脉瓣有团块状赘生物,微观检查发现念珠菌在赘生物内散在分布。