感染性流产合并感染性心内膜炎、二尖瓣赘生物及感染性和反应性关节炎：一例病例报告。
Septic abortion complicated by infective endocarditis, mitral valve vegetation, and septic and reactive arthritis: A case report.
作者信息
Kishan Raina, Wesley Shaun, Barnett George, Kauffman Robert P
机构信息
Department of Obstetrics and Gynecology, Texas Tech University Health Science Center, School of Medicine, 1400 S. Coulter St., Amarillo, TX 79106, USA.
出版信息
Case Rep Womens Health. 2022 Feb 14;34:e00398. doi: 10.1016/j.crwh.2022.e00398. eCollection 2022 Apr.
BACKGROUND
Septic abortion with multisystem involvement is associated with significant morbidity and mortality. Access to care and legalization of abortion have greatly diminished the incidence of serious sequelae worldwide. Two complications, infective endocarditis and septic arthritis, are rarely encountered in contemporary practice.
CASE
A 30-year-old woman developed infective endocarditis, septic arthritis, and reactive arthritis concurrently one week after undergoing dilation and curettage for an incomplete abortion with perioperative administration of doxycycline. She required systemic antibiotics, drainage and debridement of her right ankle, and a robotic-assisted mitral valve replacement due to septic vegetation.
CONCLUSION
Septic abortion with life-threatening systemic complications is rarely encountered in modern practice. Prompt surgical uterine evacuation and broad-spectrum antibiotics are indicated to prevent systemic complications. Multispecialty consultation is usually required when endocarditis, arthritis, and other systemic complications are encountered.
背景
伴有多系统受累的感染性流产与显著的发病率和死亡率相关。获得医疗服务和堕胎合法化已大大降低了全球严重后遗症的发生率。感染性心内膜炎和化脓性关节炎这两种并发症在当代医疗实践中很少见。
病例
一名30岁女性在因不完全流产接受刮宫术并围手术期使用强力霉素一周后，同时发生感染性心内膜炎、化脓性关节炎和反应性关节炎。由于感染性赘生物，她需要全身使用抗生素、对右脚踝进行引流和清创，以及进行机器人辅助二尖瓣置换术。
结论
在现代医疗实践中，很少遇到伴有危及生命的全身并发症的感染性流产。应及时进行手术清宫并使用广谱抗生素以预防全身并发症。当遇到心内膜炎、关节炎和其他全身并发症时，通常需要多专科会诊。
Zotero 插件