Navarrete Daniela, Hannibal David, Patil Sachin M, Patel Tarang Pankaj, Roland William
Department of Medicine and Pediatrics, PGY4 Resident, University of Missouri Hospital and Clinic, 1 Hospital Dr, Columbia, MO 65212, USA.
University of Missouri School of Medicine, MS 4, University of Missouri Hospital and Clinic, 1 Hospital Dr, Columbia, MO 65212, USA.
Case Rep Infect Dis. 2020 Nov 6;2020:8850340. doi: 10.1155/2020/8850340. eCollection 2020.
Isolated native pulmonic valve infective endocarditis (IE) is a rare occurrence. The most commonly involved valves in injection drug users are the tricuspid valve followed by mitral and then aortic valves. Most reported cases of methicillin-resistant (MRSA) IE involve multiple valves. Isolated involvement of the pulmonic valve in IE is infrequent, especially in intravenous drug users or patients with indwelling catheters, prosthetic valves, or implantable cardiac devices. Here, we report a young postpartum female patient with isolated native pulmonic valve MRSA IE with MRSA bacteremia and history of active injection drug use. A PubMed literature review revealed a single described prior case report in a postpartum female. The patient's clinical course was complicated by a large native pulmonic valve vegetation, septic pulmonary emboli, pelvic abscess, polyarticular septic arthritis, and clavicular osteomyelitis. The patient underwent bioprosthetic pulmonic valve replacement and finished six weeks of intravenous vancomycin for complete recovery.
孤立性天然肺动脉瓣感染性心内膜炎（IE）较为罕见。注射吸毒者中最常受累的瓣膜是三尖瓣，其次是二尖瓣和主动脉瓣。大多数报道的耐甲氧西林金黄色葡萄球菌（MRSA）感染性心内膜炎病例累及多个瓣膜。肺动脉瓣在感染性心内膜炎中单独受累的情况并不常见，尤其是在静脉吸毒者或有留置导管、人工瓣膜或植入式心脏装置的患者中。在此，我们报告一名年轻的产后女性患者，患有孤立性天然肺动脉瓣MRSA感染性心内膜炎伴MRSA菌血症，并有活跃的注射吸毒史。一项PubMed文献综述显示，此前仅有一篇关于产后女性病例的报道。患者临床过程复杂，伴有巨大的天然肺动脉瓣赘生物、脓毒性肺栓塞、盆腔脓肿、多关节脓毒性关节炎和锁骨骨髓炎。患者接受了生物人工肺动脉瓣置换术，并完成了六周的静脉注射万古霉素治疗以实现完全康复。
