Division of Cardiology, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora.
Division of Cardiothoracic Surgery, Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora.
Am J Med. 2015 Dec;128(12):1364-6. doi: 10.1016/j.amjmed.2015.06.053. Epub 2015 Jul 31.
Whipple endocarditis is caused by Tropheryma whipplei and is a well-described complication of Whipple's disease. Limited and small case series have been published regarding the presentation, diagnosis, and clinical course of this disease.
METHODS/RESULTS: We describe 2 cases of patients with T. whipplei endocarditis, one of which underwent a successful heart transplant.
In both cases of Whipple's endocarditis, there was a subacute prodromal phase followed by an acute rapid decompensation with severe destruction of the aortic valve, heart failure, and embolism. Because the diagnosis of T. whipplei endocarditis is typically not made until pathological examination of tissue, clinicians must have a high suspicion for it in the absence of other offending organisms, especially among middle-aged white males with sub-acute symptoms and embolic complications.
惠普尔心内膜炎由特罗斐姆·惠普尔菌引起,是惠普尔病的一种常见并发症。关于该病的临床表现、诊断和临床病程,已有有限的小病例系列报道。
方法/结果:我们描述了 2 例特罗斐姆·惠普尔菌心内膜炎患者,其中 1 例成功进行了心脏移植。
在这 2 例惠普尔心内膜炎中,均有亚急性前驱期,随后出现急性快速失代偿,主动脉瓣严重破坏、心力衰竭和栓塞。由于特罗斐姆·惠普尔菌心内膜炎的诊断通常要等到组织病理学检查才能做出,因此,在没有其他致病微生物的情况下,临床医生必须高度怀疑该病,尤其是在亚急性症状和栓塞并发症的中老年白人男性中。