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一名骨髓移植患者原生二尖瓣的黄曲霉心内膜炎

Aspergillus flavus endocarditis of the native mitral valve in a bone marrow transplant patient.

作者信息

Demir Tolga, Ergenoglu Mehmet Umit, Ekinci Abdurrahman, Tanrikulu Nursen, Sahin Mazlum, Demirsoy Ergun

机构信息

Department of Cardiovascular Surgery, Beylikduzu Kolan Hospital, Istanbul, Turkey.

Department of Cardiovascular Surgery, Kolan International Hospital, Istanbul, Turkey.

出版信息

Am J Case Rep. 2015 Jan 21;16:25-30. doi: 10.12659/AJCR.892428.

Abstract

BACKGROUND

Infective endocarditis due to Aspergillus species is an uncommon infection with a high mortality rate. It mostly occurs after the implantation of prosthetic heart valves. Parenteral nutrition, immunosuppression, broad-spectrum antibiotic regimens, and illegal intravenous drug use are the risk factors for developing infection.

CASE REPORT

We report a case of Aspergillus flavus native mitral valve endocarditis in a patient who had allogeneic stem cell transplantation in the past due to myelodysplastic syndrome.

CONCLUSIONS

Although it is rare and there is limited experience available with the diagnosis and treatment, early recognition and therapeutic intervention with systemic antifungal therapy and aggressive surgical intervention are critical to prevent further complications that may eventually lead to death. In addition, better novel diagnostic tools are needed to facilitate more accurate identification of patients with invasive Aspergillus and to permit earlier initiation of antifungal treatment.

摘要

背景

曲霉菌引起的感染性心内膜炎是一种罕见的感染,死亡率很高。它大多发生在人工心脏瓣膜植入术后。肠外营养、免疫抑制、广谱抗生素治疗方案以及非法静脉注射毒品是发生感染的危险因素。

病例报告

我们报告一例黄曲霉菌引起的原发性二尖瓣心内膜炎病例,该患者既往因骨髓增生异常综合征接受了异基因干细胞移植。

结论

尽管这种情况罕见,诊断和治疗经验有限,但早期识别并采用全身性抗真菌治疗及积极的手术干预进行治疗对于预防最终可能导致死亡的进一步并发症至关重要。此外,需要更好的新型诊断工具,以便更准确地识别侵袭性曲霉菌患者,并能更早开始抗真菌治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c0a/4311906/b09b5eda3971/amjcaserep-16-25-g001.jpg

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