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荷兰首例感染性心内膜炎病例的致命结局:一例病例报告。

Fatal outcome of first case of in infective endocarditis in the Netherlands: a case report.

作者信息

van Ommen Anne Margje Lisa Naomi, Slavenburg Serena, Diepersloot Rob, de Vries Feyens Cornelia Adriana

机构信息

Diakonessenhuis, Bosboomstraat 1, Postal Box 80250, 3508 TG Utrecht, the Netherlands.

Universitair Medisch Centrum, Heidelberglaan 100, Postal Box 85500, 3584 CX Utrecht, the Netherlands.

出版信息

Eur Heart J Case Rep. 2020 Jan 25;4(1):1-4. doi: 10.1093/ehjcr/ytz237. eCollection 2020 Feb.

Abstract

BACKGROUND

Infective endocarditis is a relatively common disease in a cardiologist's daily practice. Nowadays more detailed information about pathogens is provided to us by diagnostics such as MALDI Biotyper Massa Spectrometer. We present a case of endocarditis lenta in which was identified in the Netherlands for the first time.

CASE SUMMARY

A 58-year-old man was admitted with high suspicion of endocarditis lenta complicated by severe kidney dysfunction and anaemia. He was treated with penicillin and gentamycin. Transthoracic echocardiogram revealed a large vegetation at the mitral valve and MALDI Biotyper Massa Spectrometer (Microflex) revealed as the pathogen. The patient refused to receive blood transfusions or surgery. Due to cerebral infarction with haemorrhagic transformation, the patient died 8 days after admission.

DISCUSSION

was described in Hong Kong for the first time and is associated with endocarditis in rheumatic heart disease. To our knowledge, this is the first case reporting a fatal outcome of endocarditis due to this bacterium in the acute phase. In this case, late discovery, disease severity, and under treatment all contributed to the poor outcome. We want to share the knowledge on the existence of this bacteria.

摘要

背景

感染性心内膜炎在心脏病专家的日常临床实践中是一种相对常见的疾病。如今,诸如基质辅助激光解吸电离飞行时间质谱仪等诊断技术为我们提供了有关病原体的更详细信息。我们报告了一例缓慢性心内膜炎病例,该病例中的病原体在荷兰首次被鉴定出来。

病例摘要

一名58岁男性因高度怀疑缓慢性心内膜炎并伴有严重肾功能不全和贫血入院。他接受了青霉素和庆大霉素治疗。经胸超声心动图显示二尖瓣有一个大的赘生物,基质辅助激光解吸电离飞行时间质谱仪(Microflex)鉴定出病原体。患者拒绝接受输血或手术。由于脑梗死并伴有出血性转化,患者在入院8天后死亡。

讨论

该病原体首次在香港被描述,与风湿性心脏病的心内膜炎有关。据我们所知,这是首例报告该细菌导致的心内膜炎在急性期出现致命结局的病例。在本病例中,发现较晚、疾病严重程度以及治疗不足均导致了不良结局。我们希望分享有关这种细菌存在的知识。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/516a/7047072/f406c4059872/ytz237f1.jpg

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