Baragé Amadou, Harouna Idrissa Seydou, Mounaouir Karim, Nouamou Imad, Drighil Abdennaser, Azzouzi Leila, Habbal Rachida
Department of Cardiology, IBN ROCHD University Hospital, Casablanca, B.P, 5696, Casablanca, Morocco.
Faculty of Medicine and Pharmacy, Hassan II University of Casablanca, B.P, 5696, Casablanca, Morocco.
Ann Med Surg (Lond). 2021 Jun 20;67:102522. doi: 10.1016/j.amsu.2021.102522. eCollection 2021 Jul.
Infective endocarditis is an uncommon disease, which most often affects elderly subjects at risk or with favorable factors. Its prognosis is guarded with complications or decompensating factors that are often formidable. We report the case of an acute endocarditis decompensated by acute alithiasic cholecystitis in a 52-year-old patient, with a history of diagnosed end-stage renal failure (GFR 7 ml/min according to the MDRD) for 4 weeks, of undetermined etiology, undergoing hemodialysis, followed for aortic disease for 6 years (IAO grade II, RAO loose). After 6 weeks, the evolution was favorable under adapted and early antibiotic treatment and associated hygiene measures including gastric rest. Infective endocarditis remains a serious pathology, due to its high morbi-mortality. The association of acute infective endocarditis and acute alithiasic cholecystitis is of reserved prognosis especially on a ground of immunodepression like the end-stage chronic renal failure. This association requires a rapid and efficient management.
感染性心内膜炎是一种罕见疾病，最常影响有风险或具备有利因素的老年患者。其预后受到并发症或失代偿因素的影响，这些因素往往很严重。我们报告一例52岁患者，患有急性感染性心内膜炎，因急性结石性胆囊炎失代偿，有4周终末期肾衰竭（根据MDRD公式估算肾小球滤过率为7ml/min）病史，病因不明，正在接受血液透析，因主动脉疾病随访6年（升主动脉二级，主动脉弓松弛）。6周后，在采用适当的早期抗生素治疗及包括胃肠休息在内的相关卫生措施后，病情转好。由于其高病残率和死亡率，感染性心内膜炎仍然是一种严重疾病。急性感染性心内膜炎与急性结石性胆囊炎并存的预后不佳，尤其是在像终末期慢性肾衰竭这样的免疫抑制情况下。这种并存情况需要迅速有效的治疗。
