Carruthers M M
Am J Med Sci. 1977 Mar-Apr;273(2):203-11. doi: 10.1097/00000441-197703000-00011.
The clinical and pathological findings in two recent patients with non-salmonella enterobacterial endocarditis are described, and those of 42 patients in the literature are summarized. Most of the patients acquired their endocarditis secondary to urinary tract infection and had an acute clinical course characterized by high fever and chills. Thirty-two of these patients died, and all except one had a postmortem examination. The most frequent pathological finding was the occurrence of very large vegetations which caused relatively little destruction of the underlying valve. Prompt diagnosis and antibiotic therapy chosen on the basis of bactericidal as well as bacteriostatic activity against the individual bacterium may improve the prognosis in this disease. Results of tricuspid and pulmonic valvulectomies for bacteriologic failure in pseudomonas and in a few cases of enterobacterial endocarditis appear to warrant a surgical approach in patients with right-sided enterobacterial endocarditis who fail to respond to vigorous medical therapy.
本文描述了最近两例非沙门氏菌肠杆菌性心内膜炎患者的临床和病理表现，并总结了文献中42例患者的情况。大多数患者的心内膜炎继发于尿路感染，临床病程呈急性，以高热和寒战为特征。这些患者中有32例死亡，除1例患者外均进行了尸检。最常见的病理表现是出现非常大的赘生物，对瓣膜基础结构的破坏相对较小。基于对单个细菌的杀菌及抑菌活性选择及时诊断和抗生素治疗可能改善该病的预后。对于假单胞菌以及少数肠杆菌性心内膜炎患者因细菌学治疗失败而进行三尖瓣和肺动脉瓣切除术的结果，似乎表明对于右侧肠杆菌性心内膜炎且对积极药物治疗无反应的患者采取手术方法是合理的。
