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COVID-19 挑战:年轻免疫功能正常患者并发感染性心内膜炎。

A Challenge of COVID-19: Associated Infective Endocarditis with in a Young Immunocompetent Patient.

机构信息

Clinical Department, Medicine and Pharmacy Faculty, Dunarea de Jos University of Galati, 800008 Galati, Romania.

Morphological and Functional Science Department, Medicine and Pharmacy Faculty, Dunarea de Jos University of Galati, 800008 Galati, Romania.

出版信息

Medicina (Kaunas). 2021 Nov 26;57(12):1298. doi: 10.3390/medicina57121298.

Abstract

The COVID-19 pandemic is a new challenge for the diagnosis and treatment of infective endocarditis (IE). Fever and other unspecific symptoms of coronaviral infection could be misleading or masking its manifestations. We present the case of a young patient admitted for persistent fever, profuse sweating, headache, articular pain, myalgias, and weight loss. She reported regression taste and smell disorders compared to a month earlier when diagnosed with moderate COVID-19 pneumonia. While the RT-PCR SARS-COV-2 test was positive, she was admitted to a COVID-19 ward. Investigations of febrile syndrome revealed two positive blood cultures with and the presence of vegetations on the aortic valve, supporting a certain diagnosis of IE. After six weeks of antibiotic treatment, the patient had clinical and biologic favorable outcomes. is a common commensal related to the dental biofilm, although there were no caries in our patient. The influence of COVID-19 infection on the human microbiome by modifying the virulence of some commensal germs may be a risk factor for IE pathogenesis on native valves and requires the vigilance of clinicians for suspicion of this disease.

摘要

新型冠状病毒肺炎(COVID-19)大流行给感染性心内膜炎(IE)的诊断和治疗带来了新的挑战。冠状病毒感染的发热和其他非特异性症状可能具有误导性或掩盖其表现。我们报告了一例年轻患者,因持续发热、大量出汗、头痛、关节痛、肌痛和体重减轻而入院。与一个月前诊断为中度 COVID-19 肺炎时相比,她报告味觉和嗅觉障碍有所消退。尽管 RT-PCR SARS-COV-2 检测呈阳性,但她被收入 COVID-19 病房。发热综合征的检查显示两种阳性血培养 和主动脉瓣上存在赘生物,支持 IE 的明确诊断。经过六周的抗生素治疗,患者的临床和生物学结果均良好。 是一种与牙菌斑有关的常见共生菌,尽管我们的患者没有龋齿。COVID-19 感染通过改变一些共生菌的毒力对人类微生物组的影响可能是导致天然瓣膜 IE 发病的一个危险因素,需要临床医生警惕怀疑这种疾病。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/95fa/8707720/408ff2f4f02c/medicina-57-01298-g0A1.jpg

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