Mukaihara Kosuke, Matsumoto Kazuhisa, Kadono Jun, Imoto Yutaka
Department of Cardiovascular and Gastroenterological Surgery, Kagoshima University, Kagoshima, Japan.
Asian Cardiovasc Thorac Ann. 2017 May;25(4):296-299. doi: 10.1177/0218492316675705. Epub 2016 Oct 18.
A 74-year-old man with a history of mitral valve repair was referred to our hospital with fever and diagnosed with mitral valve endocarditis involving occlusion of the superior mesenteric artery. Bacterial cultures showed Staphylococcus lugdunensis. Despite antibiotic therapy, orthopnea ensued due to valve destruction. Emergency mitral valve replacement was performed. Computed tomography on postoperative day 10 revealed a rapidly expanding mycotic aneurysm of the superior mesenteric artery. Aneurysmectomy was undertaken. Mycotic aneurysms of the superior mesenteric artery have not been reported previously in association with Staphylococcus lugdunensis. A rapid diagnosis and prompt surgical intervention are necessary for rescue.
一名有二尖瓣修复病史的74岁男性因发热被转诊至我院，诊断为二尖瓣心内膜炎，累及肠系膜上动脉闭塞。细菌培养显示为路邓葡萄球菌。尽管进行了抗生素治疗，但由于瓣膜破坏，患者出现了端坐呼吸。遂进行了急诊二尖瓣置换术。术后第10天的计算机断层扫描显示肠系膜上动脉有一个迅速扩大的真菌性动脉瘤。于是进行了动脉瘤切除术。此前尚未有与路邓葡萄球菌相关的肠系膜上动脉真菌性动脉瘤的报道。快速诊断和及时的手术干预对于挽救生命至关重要。
