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[真菌性心内膜炎手术治疗成功的病例报告]

[A case report of successful surgical treatment of fungal endocarditis].

作者信息

Aoyagi S, Kosuga K, Arita T, Ooishi K

出版信息

Kyobu Geka. 1989 Apr;42(4):330-3.

PMID:2770072
Abstract

A successfully treated case of fungal endocarditis for native aortic and mitral valves was reported. A 56-year-old male was admitted with high fever, dyspnea on exertion and oliguria. Infective endocarditis, urinary tract infection and acute renal failure were most suspected by findings of physical examination and urinalysis, but repeated blood cultures were sterile. In the course of treatment for urinary tract infection, high fever and leucocytosis recurred and then blood cultures were positive for Candida parapsilosis. Despite intensive antifungal therapy, blood cultures were consistently positive for Candida parapsilosis. Echocardiogram showed vegetation on the aortic and mitral valve. Aortic and mitral valve replacements with prosthetic heart valves were carried out on April, 1986. Cultures of the vegetation on the mitral valve revealed Candida parapsilosis. Intensive administration of antifungal drug was done postoperatively. Postoperative course was uneventful and he was discharged in excellent condition on the 84th postoperative day. During follow-up period of 1 year, the patient has been doing very well and there were no sign of recurrence of fungal infections.

摘要

报告了一例成功治疗的原发性主动脉瓣和二尖瓣真菌性心内膜炎病例。一名56岁男性因高热、劳力性呼吸困难和少尿入院。体格检查和尿液分析结果最怀疑为感染性心内膜炎、尿路感染和急性肾衰竭,但多次血培养均无菌。在治疗尿路感染过程中,高热和白细胞增多症复发,随后血培养近平滑念珠菌呈阳性。尽管进行了强化抗真菌治疗,但血培养近平滑念珠菌一直呈阳性。超声心动图显示主动脉瓣和二尖瓣有赘生物。1986年4月进行了主动脉瓣和二尖瓣人工心脏瓣膜置换术。二尖瓣赘生物培养显示近平滑念珠菌。术后进行了强化抗真菌药物治疗。术后过程顺利,术后第84天他状况良好出院。在1年的随访期内,患者情况良好,没有真菌感染复发的迹象。

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