Haematology, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
Medicine, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK.
BMJ Case Rep. 2021 Aug 3;14(8):e242205. doi: 10.1136/bcr-2021-242205.
A 50-year-old man with no medical history of note presented with new onset of confusion and dyspnoea. He tested positive for coronavirus (COVID-19), and subsequently, was admitted to the intensive care unit due to severe sepsis and acute renal failure requiring haemodialysis. Shortly afterwards, he was intubated due to haemodynamic instability. His blood culture was positive for bacteraemia, and echocardiogram showed evidence of vegetation in the aortic valve area. He was commenced on intravenous antibiotics for infective endocarditis (IE). Following extubation, he underwent an MRI of the spine due to increasing back pain. This was suggestive of L5-S1 discitis, likely secondary to septic emboli from IE. A few days later, he developed acute ischaemia of the left toes and extensive thrombosis of the right cubital and left iliac veins. Following a prolonged hospital admission, he was discharged home and later underwent an elective forefoot amputation from which he made a good recovery.
一位 50 岁男性，无明显既往病史，因新发意识模糊和呼吸困难就诊。他新冠病毒（COVID-19）检测呈阳性，随后因严重脓毒症和急性肾衰竭需要血液透析而被收入重症监护病房。此后不久，由于血流动力学不稳定，他被插管。他的血培养阳性提示菌血症，超声心动图显示主动脉瓣区有赘生物。他开始接受静脉注射抗生素治疗感染性心内膜炎（IE）。拔管后，他因背痛加重接受了脊柱 MRI 检查。这提示 L5-S1 椎间盘炎，可能继发于 IE 的脓毒性栓子。几天后，他的左脚趾出现急性缺血，右侧肘前静脉和左侧髂静脉广泛血栓形成。经过长时间住院治疗，他出院回家，后来进行了前足截肢手术，恢复良好。
