Kurihara Ibuki, Kashiura Masahiro, Moriya Takashi, Sugawara Hitoshi
Division of General Medicine Department of Comprehensive Medicine 1 Saitama Medical Center Jichi Medical University Saitama Japan.
Department of Emergency and Critical Care Medicine Saitama Medical Center Jichi Medical University Saitama Japan.
J Gen Fam Med. 2020 Jun 7;21(5):188-190. doi: 10.1002/jgf2.347. eCollection 2020 Sep.
An 82-year-old man with untreated diabetes mellitus (DM) had anterior chest wall swelling and ulcers 2 years following blunt chest trauma. Contrast-enhanced computed tomography revealed sternal fracture with osteolytic change and subcutaneous abscess. Blood and sternal cultures were positive for methicillin-susceptible (MSSA). Transesophageal echocardiogram showed vegetation on the right coronary cusp and moderate aortic regurgitation. The patient received a diagnosis of infective endocarditis associated with chronic sternal osteomyelitis complicated by subcutaneous abscess because of MSSA. This case report showed that trivial trauma in patients with uncontrolled DM can cause chronic sternal osteomyelitis resulting in infective endocarditis.
一名82岁未治疗的糖尿病男性在钝性胸部创伤2年后出现前胸壁肿胀和溃疡。增强计算机断层扫描显示胸骨骨折伴骨质溶解改变及皮下脓肿。血液和胸骨培养结果显示对甲氧西林敏感的金黄色葡萄球菌(MSSA)呈阳性。经食管超声心动图显示右冠状动脉瓣叶有赘生物及中度主动脉瓣反流。该患者被诊断为因MSSA导致的与慢性胸骨骨髓炎并发皮下脓肿相关的感染性心内膜炎。本病例报告表明,糖尿病控制不佳患者的轻微创伤可导致慢性胸骨骨髓炎,进而引发感染性心内膜炎。