心内膜炎所致的脓毒性栓塞性卒中
Septic Embolic Stroke Resulting From Endocarditis.
作者信息
Kyaw Htoo, Shaikh Atif Z, Yaratha Gokul, Deepika Misra
机构信息
Department of Internal Medicine, The Brooklyn Hospital Center, Brooklyn, NY.
Division of Cardiology, The Brooklyn Hospital Center and Mount Sinai Beth Israel Hospital Center, New York, NY.
出版信息
Ochsner J. 2017 Summer;17(2):184-188.
BACKGROUND
, a member of the coagulase-negative staphylococci (CoNS), has been recognized as a causal organism for infective endocarditis since the 1980s. Although most CoNS have an insidious and chronic nature, they are involved in a variety of systemic infections. infective endocarditis is a rare entity but is as catastrophic as infective endocarditis and requires aggressive antibiotic therapy and, typically, valve replacement. infective endocarditis-induced septic embolic cerebrovascular accident has rarely been reported in the literature.
CASE REPORT
We present the case of a 63-year-old African American man who presented with sudden-onset aphasia and right-sided hemiplegia and was admitted for the management of cerebrovascular accident. Afterwards, he developed a fever and was found to have bacteremia, with subsequent imaging revealing vegetations of the mitral valve. Despite being treated with culture-appropriate antibiotics, he remained persistently bacteremic and required surgical mitral valve replacement.
CONCLUSION
infective endocarditis is rare but can have a malignant course and requires early surgical intervention in most cases.
背景
自20世纪80年代以来，凝固酶阴性葡萄球菌（CoNS）的一种——[具体菌种未给出]，已被确认为感染性心内膜炎的致病微生物。尽管大多数CoNS具有隐匿性和慢性特点，但它们可引发多种全身感染。[具体菌种未给出]感染性心内膜炎较为罕见，但与[具体菌种未给出]感染性心内膜炎一样具有灾难性，需要积极的抗生素治疗，通常还需要进行瓣膜置换。文献中很少报道[具体菌种未给出]感染性心内膜炎引发的感染性栓塞性脑血管意外。
病例报告
我们报告一例63岁非裔美国男性患者，该患者突发失语和右侧偏瘫，因脑血管意外入院治疗。之后，他出现发热，血培养发现[具体菌种未给出]菌血症，随后影像学检查显示二尖瓣有赘生物。尽管给予了适合培养结果的抗生素治疗，但他仍持续菌血症，需要进行二尖瓣置换手术。
结论
[具体菌种未给出]感染性心内膜炎罕见，但病程凶险，大多数情况下需要早期手术干预。
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