Department of General Internal Medicine, Akashi Medical Center, Japan.
Department of Pathology, Akashi Medical Center, Japan.
Intern Med. 2021 Nov 1;60(21):3489-3495. doi: 10.2169/internalmedicine.6186-20. Epub 2021 May 22.
Hemolytic anemia is a rarely occurring manifestation of native valve infective endocarditis. We herein report an afebrile patient with hemolytic anemia caused by Cardiobacterium hominis endocarditis. A 60-year-old Japanese man had a history of aortic root replacement and the gradual onset of general fatigue. He had hemolytic anemia. Blood cultures detected C. hominis. A transthoracic echocardiogram showed aortic valve vegetation and periannular abscess with perforation of the non-coronary cusp. Intravascular hemolysis recovered after antimicrobial therapy, surgical removal of the vegetation and abscess, and aortic valve replacement. Subacute endocarditis should be considered if patients develop hemolytic anemia with signs of chronic inflammation without a fever.
溶血性贫血是自身心脏瓣膜感染性心内膜炎的罕见表现。本文报告了一例由豪氏心杆菌心内膜炎引起的无发热性溶血性贫血患者。一名 60 岁的日本男性曾行主动脉根部置换术，逐渐出现全身乏力。他患有溶血性贫血。血培养检测出 C. hominis。经胸超声心动图显示主动脉瓣赘生物和瓣周脓肿，并伴有非冠状动脉瓣穿孔。经抗菌治疗、赘生物和脓肿切除以及主动脉瓣置换术后，血管内溶血得到恢复。如果患者出现无发热的慢性炎症迹象并伴有溶血性贫血，应考虑亚急性心内膜炎。
