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一名患有单心房、动脉导管未闭和艾森曼格综合征的年轻女性并发心内膜炎和细菌性脑脓肿:病例报告

Endocarditis and bacterial brain abscess in a young woman with a single atrium, patent ductus arteriosus, and Eisenmenger syndrome: A case report.

作者信息

Wang Wuwan, Feng Panpan, Wang Lu, Dong Qian, Huang Wei

机构信息

Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.

出版信息

Medicine (Baltimore). 2019 Sep;98(36):e17044. doi: 10.1097/MD.0000000000017044.

Abstract

RATIONALE

A single atrium is a rare congenital heart disease (CHD) involving zero atrial septal traces and preserved intact ventricular septum and atrioventricular valves, requiring careful surgical intervention. However, developing to Eisenmenger syndrome (ES) makes the surgery complicated. Based on bidirectional cardiac shunting, vegetation easily develops in case of bacterial infection.

PATIENT CONCERN AND DIAGNOSES

We reported a 35-year-old woman with a single atrium, patent ductus arteriosus, pulmonary hypertension, and ES who developed infective endocarditis on her left ventricular outflow tract and complicated cerebral abscess and who underwent challenged medical treatment.

INTERVENTION

Infection was successfully controlled after 4-time change in antibiotics over 4 months. However, surgery is complicated for her.

OUTCOMES

The patient presented a relatively good outcome during follow-up for >6 months.

LESSONS

This case report suggests that patients with complex CHD should accept surgery therapy earlier before developing ES. It is imperative to avoid invasive interventions to prevent infectious endocarditis.

摘要

原理

单心房是一种罕见的先天性心脏病(CHD),心房隔踪迹缺失,室间隔和房室瓣完整,需要谨慎的手术干预。然而,发展为艾森曼格综合征(ES)会使手术变得复杂。基于双向心脏分流,细菌感染时易形成赘生物。

患者情况与诊断

我们报告了一名35岁女性,患有单心房、动脉导管未闭、肺动脉高压和ES,其左心室流出道发生感染性心内膜炎并并发脑脓肿,接受了具有挑战性的治疗。

干预措施

4个月内4次更换抗生素后感染得到成功控制。然而,她的手术很复杂。

结果

患者在随访超过6个月期间预后相对良好。

经验教训

本病例报告表明,复杂CHD患者应在发展为ES之前尽早接受手术治疗。必须避免侵入性干预以预防感染性心内膜炎。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/390b/6739013/8a97803a9f43/medi-98-e17044-g001.jpg

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