Elikowski Waldemar, Mitkowski Przemysław, Małek-Elikowska Małgorzata, Gizło Jerzy, Chmielewska-Michalak Lidia, Łazowski Stanisław
Józef Struś Hospital, Poznań, Poland: Department of Internal Medicine.
Poznań University of Medical Sciences, Poland: 1st Department of Cardiology.
Pol Merkur Lekarski. 2017 Sep 29;43(255):125-128.
Acute acalculous cholecystitis (AAC) is a necroinflammatory disease of the gallbladder with no gallstones present. ACC is known to be a serious, even potentially lethal complication observed mainly in patients with various severe underlying conditions including trauma, burn and sepsis. Infection of cardiac implantable electronic devices may lead to cardiac device-related infective endocarditis (CDRIE). The authors describe a case of a 55-year-old female with a history of advanced heart failure and implantation/reimplantation of biventricular pacemaker/defibrillator (CRT-D) for cardiac resynchronization therapy. She was admitted presently due to the symptoms of septicemia. Echocardiography revealed CDRIE with mobile vegetations on pacemaker leads; chest computed tomography showed pulmonary infarctions. Staphylococcus aureus was cultured from the blood. Antibiotics were applied in accordance with antimicrobial susceptibility and were continued after percutaneous leads extraction and pacemaker explantation. After 6 weeks of hospitalization, nonspecific abdominal symptoms developed, ultrasonography and computed tomography confirmed AAC diagnosis. Laparoscopic cholecystectomy was performed. To the best of the authors' knowledge, the case presented is the first report of ACC in a patient with CDRIE due to infection of pacemaker leads.
急性非结石性胆囊炎（AAC）是一种胆囊的坏死性炎症性疾病，不存在胆结石。已知AAC是一种主要在包括创伤、烧伤和败血症等各种严重基础疾病患者中观察到的严重甚至可能致命的并发症。心脏植入式电子设备感染可能导致心脏设备相关感染性心内膜炎（CDRIE）。作者描述了一例55岁女性病例，该患者有晚期心力衰竭病史，因心脏再同步治疗植入/重新植入双心室起搏器/除颤器（CRT-D）。她目前因败血症症状入院。超声心动图显示CDRIE，起搏器导线上有活动的赘生物；胸部计算机断层扫描显示肺梗死。血液培养出金黄色葡萄球菌。根据药敏结果应用抗生素，并在经皮拔除导线和取出起搏器后继续使用。住院6周后，出现非特异性腹部症状，超声检查和计算机断层扫描确诊为AAC。进行了腹腔镜胆囊切除术。据作者所知，本病例是因起搏器导线感染导致CDRIE患者中首例AAC报告。
