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双瓣膜感染性心内膜炎合并系统性动脉栓塞

Double Valve Infective Endocarditis Complicated by Systemic Arterial Embolization.

作者信息

Perez Del Nogal Genesis, Bakhati Bibek, Ronen Joshua A, Garcia Fernandez Alejandra

机构信息

Internal Medicine, Texas Tech University Health Sciences Center, Odessa, USA.

Internal Medicine, University of California San Francisco School of Medicine, San Francisco, USA.

出版信息

Cureus. 2021 Oct 29;13(10):e19119. doi: 10.7759/cureus.19119. eCollection 2021 Oct.

Abstract

A 26-year-old male with a past medical history of intravenous opioid abuse was admitted with the diagnosis of double valve infective endocarditis and methicillin-resistant bacteremia. Imaging, excluding the head, was indicative of systemic arterial embolization, as abscesses had developed in the retroperitoneum and prostate. There was evidence of splenic infarct, and the presence of extensive pulmonary infiltrates indicative of showering septic foci from the heart. Antibiotic therapy was started and a transesophageal echocardiogram demonstrated mitral and tricuspid valve vegetations with a preserved ejection fraction. Fortunately, the valvular repair was successful and artificial valves were not needed. The patient had an uncomplicated postoperative course in the intensive care unit and was transferred back to the ward in stable condition. He remained on the ward for six weeks due to his unfunded status until his antibiotic course and physical rehabilitation were completed.

摘要

一名有静脉注射阿片类药物滥用病史的26岁男性因双瓣膜感染性心内膜炎和耐甲氧西林菌血症入院。除头部外的影像学检查显示有全身动脉栓塞,因为在腹膜后和前列腺已形成脓肿。有脾梗死的证据,广泛的肺部浸润表明有来自心脏的脓毒性病灶播散。开始抗生素治疗,经食管超声心动图显示二尖瓣和三尖瓣有赘生物,射血分数正常。幸运的是,瓣膜修复成功,无需人工瓣膜。患者在重症监护病房术后过程顺利,病情稳定后转回病房。由于他没有医保,在病房住了六周,直到完成抗生素疗程和身体康复。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a5a0/8614173/f1b84f1a8863/cureus-0013-00000019119-i01.jpg

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