Carneiro Herman, Rasalingam Ravi
Department of Medicine, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts.
Department of Cardiology, VA Boston Healthcare System, West Roxbury, Massachusetts.
Echocardiography. 2019 Feb;36(2):401-405. doi: 10.1111/echo.14233. Epub 2018 Dec 28.
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.
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。