Oyonarte Gómez Miguel, Del Castillo Gordillo Cesar, Rojas Romero Manuel, Loo Urbina Kenyin
Cardiovascular Center, Hospital Clinico San Borja Arriaran, Santiago, Chile.
Cardiovascular Center, Hospital Clinico San Borja Arriaran, Santiago, Chile
BMJ Case Rep. 2021 Apr 9;14(4):e241264. doi: 10.1136/bcr-2020-241264.
Human bites are an infrequent cause of emergency department visits and hospital admissions. There are rarely published cases of complicated infection, such as infective endocarditis. We present a rare case of a patient with acute infective endocarditis in a healthy native valve and purulent pericarditis from a human bite. A 40-year-old man with obesity suffered deep human bites by an adult woman, with two deep lesions in the anterior thorax and one superficial lesion in the upper abdomen and admitted in intensive care unit with septic shock and a persistent aortic murmur. Echocardiography described evidence of vegetation, perforation and severe regurgitation of aortic valve. Scanner described moderate pericardial effusion. Cardiac surgery was performed, with evidence of purulent pericardial effusion after pericardiotomy, and subsequently aortic valve replacement with a 25 mm bioprosthesis. The patient showed positive progress.
人咬伤是急诊科就诊和住院的罕见原因。很少有关于复杂感染（如感染性心内膜炎）的病例报道。我们报告了一例罕见病例，一名健康的天然瓣膜患者因被人咬伤而发生急性感染性心内膜炎和脓性心包炎。一名40岁肥胖男性被一名成年女性严重咬伤，前胸有两处深部伤口，上腹部有一处浅表伤口，因感染性休克和持续的主动脉杂音入住重症监护病房。超声心动图显示有主动脉瓣赘生物、穿孔和严重反流的迹象。扫描显示有中度心包积液。进行了心脏手术，心包切开术后发现脓性心包积液，随后用25毫米生物假体置换主动脉瓣。患者病情呈积极进展。
