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真菌性人工主动脉瓣心内膜炎和动脉内膜炎:主动脉根部赘生物的一种罕见病因。

Fungal prosthetic aortic valve endocarditis and endarteritis: An unusual cause of aortic root vegetations.

作者信息

Carneiro Herman, Rasalingam Ravi

机构信息

Department of Medicine, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts.

Department of Cardiology, VA Boston Healthcare System, West Roxbury, Massachusetts.

出版信息

Echocardiography. 2019 Feb;36(2):401-405. doi: 10.1111/echo.14233. Epub 2018 Dec 28.

Abstract

Fungal endocarditis is a relatively rare occurrence with high morbidity and mortality. Patients may have an indolent and non-specific course requiring a high index of suspicion to make a diagnosis. Here, we present the case of a 33-year-old patient who presented with fevers and acute lower limb ischemia requiring a 4-compartment fasciotomy caused by septic emboli from Candida albicans endocarditis. The patient had a large vegetation in the ascending aorta associated with a mycotic aneurysm, which is an exceedingly rare location for a vegetation. We also review the literature and summarize the typical echocardiographic appearance and vegetation locations in fungal endocarditis.

摘要

真菌性心内膜炎相对少见,但发病率和死亡率很高。患者的病程可能隐匿且不具有特异性,需要高度怀疑才能做出诊断。在此,我们报告一例33岁患者,其因白色念珠菌性心内膜炎的脓毒性栓子导致发热和急性下肢缺血,需要进行四室筋膜切开术。该患者升主动脉有一个大的赘生物,并伴有真菌性动脉瘤,赘生物位于这个位置极为罕见。我们还回顾了文献,并总结了真菌性心内膜炎典型的超声心动图表现及赘生物位置。

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