Chong Yooyoung, Han Sung Joon, Rhee Youn Ju, Kang Shin Kwang, Yu Jae Hyeon, Na Myung Hoon
Department of Thoracic and Cardiovascular Surgery, Chungnam National University School of Medicine.
Korean J Thorac Cardiovasc Surg. 2016 Oct;49(5):408-412. doi: 10.5090/kjtcs.2016.49.5.408. Epub 2016 Oct 5.
A 50-year-old female patient with visual disturbances was referred for further evaluation of a heart murmur. Fundoscopy revealed a Roth spot in both eyes. A physical examination showed peripheral signs of infective endocarditis, including Osler nodes, Janeway lesions, and splinter hemorrhages. Our preoperative diagnosis was subacute bacterial endocarditis with severe aortic regurgitation. The patient underwent aortic valve replacement and was treated with intravenous antibiotics for 6 weeks postoperatively. The patient made a remarkable recovery and was discharged without complications. We report this case of subacute endocarditis with all 4 classic peripheral signs in a patient who presented with visual disturbance.
一名50岁有视觉障碍的女性患者因心脏杂音前来进一步评估。眼底镜检查发现双眼有Roth斑。体格检查显示有感染性心内膜炎的外周体征,包括奥斯勒结节、詹韦损害和甲下线状出血。我们的术前诊断是亚急性细菌性心内膜炎伴严重主动脉瓣反流。患者接受了主动脉瓣置换术,并在术后接受了6周的静脉抗生素治疗。患者恢复显著,无并发症出院。我们报告了这例以视觉障碍为表现且具备所有4种典型外周体征的亚急性心内膜炎病例。