Glew Timothy, Feliciano Migdalia, Finkielstein Dennis, Hecht Susan, Hoffman Daryl
Department of Cardiology, Mount Sinai Beth Israel, New York, NY 10003, USA.
Department of Medicine, Mount Sinai Beth Israel, New York, NY 10003, USA.
Case Rep Cardiol. 2015;2015:732073. doi: 10.1155/2015/732073. Epub 2015 Jun 23.
A 49-year-old woman with sickle cell disease presented with one month of exertional dyspnea, weakness, and fever and was diagnosed with isolated pulmonic valve endocarditis secondary to methicillin-resistant Staphylococcus bacteremia in the setting of a peripherally inserted central venous catheter. Chest computerized tomography showed multiple bilateral pulmonary nodular opacities consistent with septic emboli. Transthoracic and transesophageal echocardiograms revealed a large echodensity on the pulmonic valve requiring vegetation excision and pulmonic valve repair. In conclusion, isolated pulmonic valve endocarditis is a rare cause of infective endocarditis that warrants a high index of clinical suspicion. Furthermore the management of patients with sickle cell disease and endocarditis requires special consideration.
一名49岁镰状细胞病女性患者,出现劳力性呼吸困难、乏力和发热1个月,被诊断为因耐甲氧西林金黄色葡萄球菌菌血症继发的孤立性肺动脉瓣心内膜炎,患者当时正在使用外周静脉置入中心静脉导管。胸部计算机断层扫描显示双侧多发肺结节状混浊,符合脓毒性栓子表现。经胸和经食管超声心动图显示肺动脉瓣上有一大回声密度影,需要切除赘生物并进行肺动脉瓣修复。总之,孤立性肺动脉瓣心内膜炎是感染性心内膜炎的罕见病因,需要高度的临床怀疑指数。此外,镰状细胞病合并心内膜炎患者的治疗需要特别考虑。