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心脏手术后的奇美拉分枝杆菌感染:加拿大首例疫情

Mycobacterium chimaera Infection After Cardiac Surgery: First Canadian Outbreak.

作者信息

Hamad Raphael, Noly Pierre-Emmanuel, Perrault Louis P, Pellerin Michel, Demers Philippe

机构信息

Department of Cardiac Surgery, Montreal Heart Institute, Université de Montréal, Montreal, Québec, Canada.

Department of Cardiac Surgery, Montreal Heart Institute, Université de Montréal, Montreal, Québec, Canada.

出版信息

Ann Thorac Surg. 2017 Jul;104(1):e43-e45. doi: 10.1016/j.athoracsur.2017.01.115.

Abstract

Recently reported in Europe and United States, disseminated Mycobacterium chimaera infection is a novel clinical entity linked to point contamination of Stockert 3T heater-cooler units used for cardiopulmonary bypass. We present here the first two cases in Canada. Both patients presented with nonspecific extracardiac symptoms 1 year after undergoing minimally invasive mitral surgical repair. Before the right diagnosis was established, the patients were initially treated with prednisone for suspected sarcoidosis. One patient is currently improving, and the other needed mitral valve repair despite aggressive treatment. Because of the nonspecific mode and timing of presentation, a high index of suspicion is necessary for the diagnosis of M. chimaera infection.

摘要

近期欧美报道,播散性嵌合体分枝杆菌感染是一种新型临床病症,与用于体外循环的Stockert 3T变温水箱的点状污染有关。我们在此报告加拿大的首例两例病例。两名患者在接受微创二尖瓣手术修复1年后均出现非特异性心外症状。在确诊之前,患者最初因疑似结节病接受泼尼松治疗。一名患者目前病情正在好转,另一名患者尽管接受了积极治疗仍需要进行二尖瓣修复。由于其非特异性的表现方式和时间,对于嵌合体分枝杆菌感染的诊断需要高度怀疑。

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