Novotny William Edward, Keel Cynthia P
Department of Pediatrics, East Carolina University, Brody School of Medicine, Greenville, NC, USA.
Vidant Medical Center, Pediatric Intensive Care Unit, Greenville, NC, USA.
Ann Pediatr Cardiol. 2020 Apr-Jun;13(2):144-146. doi: 10.4103/apc.APC_194_19. Epub 2020 Apr 25.
A broom straw was ingested and penetrated the esophageal wall, the pericardial space and its tip became lodged in the coronary sinus. Bacterial pericarditis and then fungal endocarditis ensued but were temporally separated by an asymptomatic 6-month period. On transthoracic echocardiography, the straw was mistakenly identified to be a "prominent Thebesian valve." This child survived both life-threatening infections. The occurrence of infections caused by unusual organisms in the setting of immunocompetence highlights the need for a high index of suspicion for the presence of a causative foreign body.
一根扫帚秸秆被吞食，穿透食管壁，进入心包腔，其尖端卡在冠状窦。随后发生细菌性心包炎，接着是真菌性心内膜炎，但中间有6个月的无症状期。经胸超声心动图检查时，秸秆被误认是一个“明显的Thebesian瓣”。这个孩子在两次危及生命的感染中幸存下来。在免疫功能正常的情况下由不寻常病原体引起感染，这突出表明需要高度怀疑有致病异物存在。
