近平滑念珠菌引起的真菌性人工瓣膜心内膜炎：一例报告
Fungal Prosthetic Valve Endocarditis by Candida parapsilosis: A Case Report.
作者信息
Shokohi Tahereh, Nouraei Seyed Mahmood, Afsarian Mohammad Hosein, Najafi Narges, Mehdipour Shirin
机构信息
Department of Parasitology and Mycology, Mazandaran University of Medical Sciences, Sari, IR Iran ; Invasive Fungi Research center, Mazandaran University of Medical Sciences, Sari, IR Iran.
Mazandaran Heart Center, Mazandaran University of Medical Sciences, Sari, IR Iran.
出版信息
Jundishapur J Microbiol. 2014 Mar;7(3):e9428. doi: 10.5812/jjm.9428. Epub 2014 Mar 1.
INTRODUCTION
Fungal prosthetic valve endocarditis (PVE) is rare but serious complication of valve replacement surgery. Candida species, particularly Candida albicans is the most common isolated pathogen in fungal PVE (1-6%of cases).
CASE PRESENTATION
We describe a 35-year-old woman who underwent mechanical mitral valve replacement about 3 years ago. She was admitted with neurological symptoms and later with dyspnea and hypotension. Transesophageal echocardiography showed large and mobile prosthetic valve vegetation. She underwent mitral valve surgery. The explanted valve and vegetation revealed lots of budding yeasts and the isolated yeast was identified as C. parapsilosis. Amphotericin B and broad spectrum antibiotic were started immediately. Unfortunately, the patient died two days after surgery, due to sepsis probably related to the candidemia.
CONCLUSIONS
Fungal endocarditis is uncommon infection, but it is a serious problem in patients with prosthetic valve. Fungal PVE can occur years after the surgery, thus long-term follow-up is essential.
引言
真菌性人工瓣膜心内膜炎（PVE）是瓣膜置换手术罕见但严重的并发症。念珠菌属，尤其是白色念珠菌是真菌性PVE中最常见的分离病原体（占病例的1-6%）。
病例介绍
我们描述了一名35岁女性，约3年前接受了机械二尖瓣置换术。她因神经症状入院，后来出现呼吸困难和低血压。经食管超声心动图显示人工瓣膜上有大的活动赘生物。她接受了二尖瓣手术。取出的瓣膜和赘生物显示有大量芽生酵母，分离出的酵母被鉴定为近平滑念珠菌。立即开始使用两性霉素B和广谱抗生素。不幸的是，患者术后两天死亡，可能死于与念珠菌血症相关的败血症。
结论
真菌性心内膜炎是一种罕见的感染，但在人工瓣膜患者中是一个严重问题。真菌性PVE可在手术后数年发生，因此长期随访至关重要。
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