Horimoto Koshin, Kubo Toshihiko, Matsusaka Hidenori, Baba Hironori, Umesue Masayoshi
Department of Cardiology, Matsuyama Red Cross Hospital, Japan.
Intern Med. 2015;54(7):797-800. doi: 10.2169/internalmedicine.54.3374. Epub 2015 Apr 1.
We herein report the case of 34-year-old woman with acute tricuspid valve infective endocarditis (IE) associated with a ruptured sinus of Valsalva and multiple septic pulmonary emboli. She had no history of medical problems, except for atopic dermatitis (AD). Blood cultures identified methicillin-sensitive Staphylococcus aureus. Despite the administration of two months of antibiotic therapy, the patient experienced recurrent pulmonary emboli and developed heart failure due to a left-to-right shunt, whereas the area of vegetation did not change in size. She subsequently underwent surgery for shunt closure and tricuspid valve replacement. The AD was thought to be the cause of the patient's bacteremia, which consequently resulted in aggressive right-sided IE.
我们在此报告一例34岁女性，患有急性三尖瓣感染性心内膜炎（IE），伴有瓦氏窦破裂和多发性感染性肺栓塞。除特应性皮炎（AD）外，她无其他病史。血培养鉴定出对甲氧西林敏感的金黄色葡萄球菌。尽管给予了两个月的抗生素治疗，但患者仍反复发生肺栓塞，并因左向右分流而发展为心力衰竭，而赘生物面积大小未变。随后，她接受了手术以闭合分流并置换三尖瓣。AD被认为是患者菌血症的病因，进而导致侵袭性右侧IE。
