由惠普尔心内膜炎引起的血培养阴性的心内膜炎
Blood Culture-negative Endocarditis Caused by : Whipple's endocarditis.
作者信息
Knol Silke, Nijhuis Rogier L, Geeraedts Felix, Linssen Gerard Cm
机构信息
Department of Cardiology, Hospital Group Twente (ZGT), Almelo and Hengelo, The Netherlands.
Laboratory Microbiology Twente Achterhoek (LabMicTA), Hengelo, The Netherlands.
出版信息
Eur J Case Rep Intern Med. 2021 May 19;8(5):002596. doi: 10.12890/2021_002596. eCollection 2021.
CASE DESCRIPTION
A 67-year-old man was admitted with progressive heart failure due to blood culture-negative endocarditis of the aortic valve. Urgent aortic valve replacement was needed. Polymerase chain reaction (PCR) testing of samples of the explanted aortic valve revealed . The patient received ceftriaxone, followed by long-term co-trimoxazole. Recent arthralgia may have been a diagnostic clue.
CONCLUSION
Whipple's endocarditis should be considered in patients with arthralgia and blood culture-negative endocarditis (BCNIE).
LEARNING POINTS
Whipple's endocarditis should be considered in patients with symptoms of arthralgia and blood culture-negative endocarditis (BCNIE).Serum polymerase chain reaction is the main diagnostic test.Both physician awareness and multidisciplinary management by regional endocarditis teams are recommended strategies to provide optimal patient care.
病例描述
一名67岁男性因主动脉瓣血培养阴性的心内膜炎导致进行性心力衰竭入院。需要紧急进行主动脉瓣置换。对切除的主动脉瓣样本进行聚合酶链反应（PCR）检测发现…… 患者接受了头孢曲松治疗，随后长期服用复方新诺明。近期的关节痛可能是一个诊断线索。
结论
对于有关节痛和血培养阴性的心内膜炎（BCNIE）患者，应考虑惠普尔心内膜炎。
学习要点
有关节痛症状和血培养阴性的心内膜炎（BCNIE）患者应考虑惠普尔心内膜炎。血清聚合酶链反应是主要的诊断检测方法。建议医生提高认识以及由区域心内膜炎团队进行多学科管理，这是为患者提供最佳护理的策略。
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