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孤立性左房感染性壁层心内膜炎

Isolated Left Atrial Infective Mural Endocarditis.

作者信息

Hosokawa Saki, Okayama Hideki, Hiasa Go, Kawamura Go, Shigematsu Tatsuya, Takahashi Tatsunori, Kawada Yoshitaka, Yamada Tadakatsu, Matsuoka Hiroshi, Kazatani Yukio

机构信息

Department of Cardiology, Ehime Prefectural Central Hospital, Japan.

出版信息

Intern Med. 2018 Apr 1;57(7):957-960. doi: 10.2169/internalmedicine.9559-17. Epub 2017 Dec 8.

DOI:10.2169/internalmedicine.9559-17
PMID:29225261
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5919852/
Abstract

A 52-year-old man presented with a fever and malaise. Transthoracic echocardiogram was performed because of a holosystolic murmur, which showed mitral valve prolapse and a regurgitation jet toward the posterior wall of the left atrium. There was no apparent vegetation at any valves. Blood cultures were positive for Streptococcus mitis/oralis. Transesophageal echocardiogram revealed vegetation only at the posterior wall of the left atrium exposed to the mitral regurgitant jet. We diagnosed this condition as infective mural endocarditis. This case highlighted the need for a detailed observation of the valves and the atrial wall when infective endocarditis is suspected.

摘要

一名52岁男性出现发热和全身不适。因全收缩期杂音进行了经胸超声心动图检查，结果显示二尖瓣脱垂以及朝向左心房后壁的反流束。各瓣膜均未发现明显赘生物。血培养结果显示缓症链球菌/口腔链球菌阳性。经食管超声心动图仅在暴露于二尖瓣反流束的左心房后壁发现赘生物。我们将此病例诊断为感染性壁性心内膜炎。该病例强调了在怀疑感染性心内膜炎时，需要对瓣膜和心房壁进行详细观察。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6392/5919852/d8e3acafc1c7/1349-7235-57-0957-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6392/5919852/6df0fb417871/1349-7235-57-0957-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6392/5919852/22884ab5adf8/1349-7235-57-0957-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6392/5919852/d8e3acafc1c7/1349-7235-57-0957-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6392/5919852/6df0fb417871/1349-7235-57-0957-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6392/5919852/22884ab5adf8/1349-7235-57-0957-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6392/5919852/d8e3acafc1c7/1349-7235-57-0957-g004.jpg

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Left atrial mural endocarditis secondary to mitral valve jet lesion.
Circulation. 2015 Apr 28;131(17):1529-30. doi: 10.1161/CIRCULATIONAHA.115.015626.
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Nat Rev Cardiol. 2014 Jan;11(1):35-50. doi: 10.1038/nrcardio.2013.174. Epub 2013 Nov 19.
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Mitral-Aortic Intervalvular Fibrosa: A Hidden Region Associated With Infective Endocarditis Complications.二尖瓣-主动脉瓣间纤维：一个与感染性心内膜炎并发症相关的隐匿区域。
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