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一例原发性细菌性心包炎伴反复心脏压塞

A Case of Primary Bacterial Pericarditis with Recurrent Cardiac Tamponade.

作者信息

Yoshizane Takashi, Yamamoto Takeshi, Hayashi Hiroshi, Kitamura Mitsunobu, Miyachi Hideki, Hosokawa Yusuke, Akutsu Koichi, Shimizu Wataru

机构信息

Division of Cardiovascular Intensive Care, Nippon Medical School Hospital.

Department of Cardiology, Nippon Medical School.

出版信息

J Nippon Med Sch. 2017;84(3):133-138. doi: 10.1272/jnms.84.133.

Abstract

Cardiac tamponade is an important and potentially lethal complication of acute pericarditis. However, recurrence of cardiac tamponade is rare when it is treated appropriately. We present a 49-year-old man with bacterial pericarditis and recurrent cardiac tamponade, which was caused by the rupture of an upper part of the left atrium (LA). According to the autopsy findings, bacteremia from Staphylococcus aureus developed on a substrate of poorly controlled diabetes mellitus and spread to the pericardium via the blood. Subsequently, tissue necrosis developed from the pulmonary trunk and aorta to the LA, leading to recurrence of cardiac rupture and cardiac tamponade.

摘要

心脏压塞是急性心包炎的一种重要且可能致命的并发症。然而,若得到恰当治疗,心脏压塞复发的情况较为罕见。我们报告一例49岁男性,患有细菌性心包炎并反复发生心脏压塞,其病因是左心房上部破裂。根据尸检结果,金黄色葡萄球菌菌血症在糖尿病控制不佳的基础上发生,并通过血液扩散至心包。随后,从肺动脉干和主动脉到左心房出现组织坏死,导致心脏破裂和心脏压塞复发。

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