Curri Francesca, Da Porto Andrea, Casarsa Viviana, Albini Daria, Minen Giorgio, Sechi Leonardo A
Department of Experimental and Clinical Medical Sciences, Clinica Medica, University Hospital, University of Udine, Udine, Italy.
Department of Cardiac Sciences, Cardiology, University Hospital, University of Udine, Udine, Italy.
Eur J Case Rep Intern Med. 2021 Feb 1;8(3):002263. doi: 10.12890/2021_002263. eCollection 2021.
We report a case of mechanical mitral valve endocarditis associated with miliary disseminated bacillus Calmette-Guerin (BCG) infection following intravesical instillations for minimally invasive bladder cancer in a 65-year-old man. The diagnosis was established by echocardiographic evidence of vegetation on the prosthetic mitral valve, miliary lesions in the lungs and evidence of bloodstream infection sustained by . We successfully treated the patient with the classical regimen of quadruple antituberculous therapy.
To consider endocarditis as an extra-pulmonary manifestation of infection, especially in the presence of predisposing heart conditions and risk factors.To be careful of drug interactions among warfarin, rifampin and amiodarone.
我们报告了一例65岁男性患者，在接受微创膀胱癌膀胱内灌注卡介苗（BCG）后发生机械性二尖瓣心内膜炎，并伴有粟粒性播散性卡介苗感染。通过经胸超声心动图证实人工二尖瓣上有赘生物、肺部有粟粒性病变以及血行感染证据来确诊。我们采用经典的四联抗结核治疗方案成功治愈了该患者。
应将心内膜炎视为卡介苗感染的肺外表现，尤其是在存在易患心脏病和危险因素的情况下。要注意华法林、利福平和胺碘酮之间的药物相互作用。
