三尖瓣心内膜炎中的脓毒性肺栓塞和系统性栓塞
Septic pulmonary and systemic embolism in tricuspid endocarditis.
作者信息
Nii Takuro, Yoshikawa Hideto, Okabe Taichi, Tachibana Isao
机构信息
Department of Medicine, Nissay Hospital, Nippon Life Saiseikai Public Interest Incorporated Foundation, Osaka, Japan.
出版信息
BMJ Case Rep. 2014 Nov 24;2014:bcr2014206569. doi: 10.1136/bcr-2014-206569.
Abstract
A 28-year-old woman presenting with fever was referred to our hospital and diagnosed as septic pulmonary embolism secondary to tricuspid valve endocarditis. Although antibiotic therapy was initiated, she further showed multiple complications including Janeway lesions and cerebral infarctions, suggestive of septic systemic embolism. Transoesophageal echocardiography detected a right-to-left shunt through a patent foramen ovale (PFO). The patient was successfully treated with surgical tricuspid valvuloplasty and PFO closure. Paradoxical systemic embolism may occur in patients with septic pulmonary embolism through the PFO.
摘要
一名28岁发热女性被转诊至我院，诊断为继发于三尖瓣心内膜炎的感染性肺栓塞。尽管开始了抗生素治疗，但她进一步出现了包括詹韦损害和脑梗死在内的多种并发症，提示感染性全身栓塞。经食管超声心动图检测到通过卵圆孔未闭（PFO）的右向左分流。该患者通过手术三尖瓣成形术和PFO封堵术成功治愈。感染性肺栓塞患者可能通过PFO发生反常性全身栓塞。
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