Fujita Akira, Kamota Takahiro, Sato Masafumi, Okada Haruhiko
Department of Cardiovascular Surgery, Tokuyama Central Hospital, Shunan, Japan.
Kyobu Geka. 2013 Jul;66(7):593-7.
A 76-year-old woman, who had underwent aortic valve replacement (AVR) 2 months previously, was admitted to our hospital for persistent pyrexia. Her blood culture results were negative. A new heart murmur was noted on day 19 after admission. Esophageal echocardiography indicated the usual prosthetic valve endocarditis (PVE) findings, including a hyperechoic area in the prosthetic valve and deterioration of regurgitation. Medication was unable to prevent heart failure on day 39 after admission. Subsequently, we performed redo AVR and annulus debridement, but she died due to complicated sepsis in the postoperative period. As reports of Aspergillus PVE are scarce, its precise prognosis remains unknown. However, given that the prognoses of infective endocarditis related to Aspergillus species are poor, we believe that Aspergillus PVE can be fatal. Therefore, we suggest that Aspergillus PVE should be diagnosed as soon as possible, and that prompt surgery should be performed to improve the patient prognosis.
一名76岁女性，2个月前接受了主动脉瓣置换术（AVR），因持续发热入住我院。她的血培养结果为阴性。入院后第19天发现新的心脏杂音。食管超声心动图显示了人工瓣膜心内膜炎（PVE）的常见表现，包括人工瓣膜内的高回声区和反流恶化。入院后第39天，药物治疗无法预防心力衰竭。随后，我们进行了再次AVR和瓣环清创术，但她在术后因并发败血症死亡。由于曲霉菌性PVE的报道很少，其确切预后尚不清楚。然而，鉴于与曲霉菌属相关的感染性心内膜炎预后较差，我们认为曲霉菌性PVE可能是致命的。因此，我们建议应尽快诊断曲霉菌性PVE，并应及时进行手术以改善患者预后。
