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由急性细菌性心内膜炎引起的白细胞碎裂性血管炎可通过抗生素治疗得到缓解。

Leucocytoclastic vasculitis due to acute bacterial endocarditis resolves with antibiotics.

机构信息

Internal Medicine, University of Louisville, Louisville, Kentucky, USA

Internal Medicine, University of Louisville, Louisville, Kentucky, USA.

出版信息

BMJ Case Rep. 2021 Jan 25;14(1):e239961. doi: 10.1136/bcr-2020-239961.

Abstract

Infective endocarditis is associated with a variety of clinical signs, but its association with multisystem vasculitis is rarely reported. A high index of suspicion is necessary to differentiate a primary autoimmune vasculitis from an infectious cause as the wrong treatment can lead to significant morbidity and mortality. We present a 71-year-old female patient with negative blood cultures, on antibiotics for recent bacteraemia, who presented with cutaneous and renal leucocytoclastic vasculitis. Workup revealed a vegetation adjacent to her right atrial pacemaker lead consistent with infective endocarditis and her vasculitis completely resolved with appropriate antibiotics.

摘要

感染性心内膜炎与多种临床症状相关,但与多系统血管炎相关的情况很少见报告。鉴别原发性自身免疫性血管炎和感染性病因需要高度警惕,因为错误的治疗可能导致严重的发病率和死亡率。我们报告了一例 71 岁女性患者,其血液培养阴性,近期菌血症正在使用抗生素治疗,表现为皮肤和肾脏白细胞碎裂性血管炎。检查发现她的右心房起搏器导线上有一个赘生物,符合感染性心内膜炎的诊断,适当的抗生素治疗后她的血管炎完全缓解。

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