Lamaa Nader, Bromberg Romina, Foroughi Maryam, Danckers Mauricio
Internal Medicine, Aventura Hospital and Medical Center, Aventura, Florida, USA.
BMJ Case Rep. 2018 Dec 4;11(1):e226681. doi: 10.1136/bcr-2018-226681.
Septic shock is the most common type of shock in the intensive care unit with an associated mortality close to 50%. Infective endocarditis (IE) is a rare cause of septic shock but carries significant morbidity and mortality. Group B IE (GBS-IE) is an invasive infection with an incidence of approximately 1.7%. It affects immunocompromised patients such as intravenous drug users, alcoholics, those with HIV and elderly among others. IE with severe acute valvular heart disease challenges physicians when assessing fluid status during the early resuscitation in patients with septic shock. We present a case of GBS-IE complicated by severe acute aortic regurgitation with rapidly progressive acute respiratory failure in the setting of septic shock management.
感染性休克是重症监护病房中最常见的休克类型，其相关死亡率接近50%。感染性心内膜炎（IE）是感染性休克的罕见病因，但具有显著的发病率和死亡率。B组IE（GBS-IE）是一种侵袭性感染，发病率约为1.7%。它影响免疫功能低下的患者，如静脉吸毒者、酗酒者、艾滋病毒感染者和老年人等。在感染性休克患者的早期复苏过程中，伴有严重急性瓣膜性心脏病的IE在评估液体状态时给医生带来了挑战。我们报告一例GBS-IE合并严重急性主动脉瓣反流，并在感染性休克管理过程中迅速进展为急性呼吸衰竭的病例。
