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常见临床表现的罕见病因:孤立性肺动脉瓣心内膜炎,又是一个模仿者。

Rare cause for a common presentation: isolated pulmonary valve endocarditis yet another mimicker.

作者信息

Reza Ahmed Shameem, Anand Dharmesh, Cheng Sing Huey, Anand Dharampal

机构信息

Department of Cardiology, Western Health, Melbourne, Victoria, Australia.

Department of Cardiology, The Townsville Hospital, Townsville, Australia.

出版信息

BMJ Case Rep. 2018 Jul 18;2018:bcr-2018-224703. doi: 10.1136/bcr-2018-224703.

Abstract

Isolated pulmonary valve endocarditis (PVE) is a rare condition. Known risk factors in previous case reports were intravenous drug abuse and congenital heart disease. Epidemiology of PVE has been changing. It is now being reported specially following invasive healthcare-related procedures even in patients with structurally normal heart. Vast majority of patients present with respiratory symptoms and diagnosis of endocarditis may be challenging unless there is high index of suspicion. Various microorganisms had been isolated as aetiological agents; however, is being increasingly isolated. PVE mostly managed conservatively with intravenous antibiotics with option for surgical intervention in specific situations. We present a patient with isolated PVE due to following colonoscopy and polypectomy with predisposing risk factor of alcohol excess, mimicking clinically as pneumonia and radiologically as a neoplastic lesion.

摘要

孤立性肺动脉瓣心内膜炎(PVE)是一种罕见疾病。既往病例报告中已知的危险因素为静脉药物滥用和先天性心脏病。PVE的流行病学一直在变化。现在特别报道其发生于侵入性医疗相关操作之后,甚至在心脏结构正常的患者中。绝大多数患者表现出呼吸道症状,除非高度怀疑,否则心内膜炎的诊断可能具有挑战性。已分离出多种微生物作为病原体;然而, 越来越多地被分离出来。PVE大多采用静脉抗生素保守治疗,在特定情况下可选择手术干预。我们报告一例因结肠镜检查和息肉切除术后发生孤立性PVE的患者,其易患危险因素为过度饮酒,临床症状类似肺炎,影像学表现类似肿瘤性病变。

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本文引用的文献

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Korean J Intern Med. 2018 Jan;33(1):102-112. doi: 10.3904/kjim.2016.106. Epub 2017 Jun 2.
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