Martel-Arquette A, Tjostheim S S, Miller J, Carlson J, Mans C
Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, 2015 Linden Dr., Madison, WI 53706, USA.
Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, 2015 Linden Dr., Madison, WI 53706, USA.
J Vet Cardiol. 2019 Feb;21:49-56. doi: 10.1016/j.jvc.2018.08.003. Epub 2018 Dec 13.
A 4-year-old intact male mini lop rabbit (Oryctolagus cuniculus) was presented with a 2-week history of severe progressive lethargy. A right parasternal continuous heart murmur and an irregular rhythm were detected on physical examination. Echocardiography identified vegetative aortic and tricuspid valve (TV) endocarditis. There was an aortocavitary fistula between the right sinus of Valsalva into the right ventricle, creating a left-to-right intracardiac shunt. Based on the echocardiographic findings, it was suspected that the infection originated in the aortic valve, eroded through the periannular tissue, and secondarily infected the TV. Pleural and peritoneal effusion secondary to right-sided congestive heart failure was also found during the echocardiogram. Atrial fibrillation, conducted with a left bundle branch block morphology, was identified using electrocardiography. Necropsy findings directly correlated with the echocardiographic diagnosis; marked periodontal disease was also identified. Aerobic culture of the aortic and tricuspid vegetations resulted in significant growth of Haemophilus parainfluenzae. Haemophilus spp. belong to a group of similar gram-negative coccobacillus bacteria (HACEK group), which can act as an uncommon cause of endocarditis in humans. HACEK endocarditis is most commonly associated with oral infection and/or dental procedures in people. This is the first case report of a rabbit with periannular complications of infective endocarditis. It remains unknown whether dental disease resulted in endocarditis in this patient.
一只4岁未绝育的雄性迷你垂耳兔（穴兔）出现了持续2周的严重进行性嗜睡症状。体格检查发现胸骨旁右侧有连续性心脏杂音和心律不齐。超声心动图检查发现主动脉瓣和三尖瓣感染性心内膜炎，在主动脉窦右窦与右心室之间存在主动脉腔瘘，形成了心内从左向右的分流。根据超声心动图检查结果，怀疑感染起源于主动脉瓣，侵蚀了瓣环周围组织，继而感染了三尖瓣。超声心动图检查期间还发现了右侧充血性心力衰竭继发的胸腔和腹腔积液。通过心电图检查确定为心房颤动，其传导形态为左束支传导阻滞。尸检结果与超声心动图诊断直接相关，还发现了明显的牙周病。对主动脉瓣和三尖瓣赘生物进行需氧培养，结果显示副流感嗜血杆菌大量生长。嗜血杆菌属属于一组相似的革兰氏阴性球杆菌（HACEK组），可作为人类心内膜炎的罕见病因。HACEK心内膜炎在人类中最常与口腔感染和/或牙科手术有关。这是第一例关于兔感染性心内膜炎瓣环周围并发症的病例报告。尚不清楚该患者的牙病是否导致了心内膜炎。
