二尖瓣装置保留的左心耳赘生物表现为内源性眼内炎的罕见病例报告。
An unusual case report of mitral valve apparatus sparing left atrial appendage vegetation presenting as endogenous endophthalmitis.
作者信息
Kumar Rupesh, Bansal Vidur, Halder Vikram, Chakraborty Nirupan Sekhar, Gourav Krishna Prasad
机构信息
Department of Cardiothoracic and Vascular Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India.
Department of Anesthesia, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
出版信息
Egypt Heart J. 2021 Jun 6;73(1):52. doi: 10.1186/s43044-021-00176-3.
BACKGROUND
Ocular manifestations of infective endocarditis are nonspecific and rare. Endophthalmitis, retinal artery occlusion, Roth spots and vitreal and retinal infiltrations can all be seen with infective endocarditis. Also, infective endocarditis involving the left atrial appendage with no involvement of the mitral valve apparatus is a rarity.
CASE PRESENTATION
Here we report a case of infective endocarditis of the heart involving the left atrial appendage presenting with features of endogenous endophthalmitis which ultimately progressed to phthisis bulbi with subtle cardiac symptoms in a previous healthy young adult.
CONCLUSION
Infective endocarditis involving the left chambers of the heart carries an inherent high risk of systemic embolization. Panophthalmitis which is considered to be the most severe form of endogenous endophthalmitis is a rare presenting feature. Although a definitive treatment algorithm is lacking, early surgery and parenteral antibiotics along with local antibiotic injections could help to save the vision.
背景
感染性心内膜炎的眼部表现不具有特异性且较为罕见。感染性心内膜炎可出现眼内炎、视网膜动脉阻塞、 Roth 斑以及玻璃体和视网膜浸润。此外，累及左心耳而不累及二尖瓣装置的感染性心内膜炎十分罕见。
病例报告
在此，我们报告一例累及左心耳的心脏感染性心内膜炎病例，该病例表现为内源性眼内炎特征，最终进展为眼球痨，而心脏症状轻微，患者为既往健康的年轻成年人。
结论
累及心脏左腔的感染性心内膜炎存在全身性栓塞的固有高风险。全眼球炎被认为是内源性眼内炎最严重的形式，是一种罕见的表现特征。尽管缺乏明确的治疗方案，但早期手术、胃肠外抗生素治疗以及局部抗生素注射有助于挽救视力。
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