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与血管闭合装置相关的甲氧西林敏感细菌性动脉内膜炎

Methicillin-sensitive bacterial endarteritis associated with vascular closure device.

作者信息

Alves Rosa, Judas Tiago, Vieira João Valença, Delerue Francisca

机构信息

Department of Internal Medicine, Hospital Garcia de Orta, Almada, Portugal.

Deparment of Vascular Surgery, Hospital Garcia de Orta, Almada, Portugal.

出版信息

BMJ Case Rep. 2020 Jan 19;13(1):e232885. doi: 10.1136/bcr-2019-232885.

Abstract

Percutaneous endovascular procedures (PEPs) are increasingly common in clinical practice. Percutaneous closure devices (PCD) ensure safe and immediate haemostasis, reducing the length of hospitalisation and improving patient comfort. Infectious complications are rare. We present the case of a 65-year-old man who was admitted to hospital because of fever and weight loss. He had a history of carotid arterial disease, having been submitted to a PEP 3 weeks before. On admission, he presented feverishly. Anaemia and elevated inflammatory parameters were detected on basic chemistry. Blood cultures isolated methicillin-sensitive and antibiotic therapy was started. He maintained fever and developed signs of right lower limb ischemia. Bacterial endocarditis was ruled out. Positron emission tomography (PET)-scan revealed inflammatory activity involving the right femoral artery (RFA). Bacterial femoral endarteritis was confirmed on surgical exploration, which documented the presence of infected PCD and occlusion of RFA. After surgery, apyrexia and improvement of ischaemic signs were achieved.

摘要

经皮血管内介入手术(PEPs)在临床实践中越来越常见。经皮闭合装置(PCD)可确保安全且立即止血,缩短住院时间并提高患者舒适度。感染性并发症罕见。我们报告一例65岁男性患者,因发热和体重减轻入院。他有颈动脉疾病史,3周前接受了经皮血管内介入手术。入院时,他发热。基础化学检查发现贫血和炎症指标升高。血培养分离出对甲氧西林敏感的细菌,开始抗生素治疗。他持续发热并出现右下肢缺血迹象。排除了细菌性心内膜炎。正电子发射断层扫描(PET)显示右股动脉(RFA)有炎症活动。手术探查证实为细菌性股动脉内膜炎,记录显示存在感染的经皮闭合装置及右股动脉闭塞。术后,患者退热,缺血症状改善。

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本文引用的文献

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18F-FDG PET/CT in the Management of Aortitis.18F-FDG PET/CT 在大动脉炎治疗中的应用。
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Rev Infect Dis. 1991 Jul-Aug;13(4):620-3. doi: 10.1093/clinids/13.4.620.

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