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二尖瓣瓣环成形术后患者的二尖瓣心内膜炎。

mitral valve endocarditis in a patient with a history of mitral valve annuloplasty.

机构信息

School of Medicine, UT Southwestern, Dallas, Texas, USA

Department of Cardiovascular and Thoracic Surgery, UT Southwestern, Dallas, Texas, USA.

出版信息

BMJ Case Rep. 2022 Apr 29;15(4):e247033. doi: 10.1136/bcr-2021-247033.

Abstract

A woman with a history of congenital heart disease status post multiple valve operations including mitral valve repair presented with 2 months of low back pain and general malaise. Blood cultures returned positive for Gram-positive cocci. While transthoracic echocardiography did not identify vegetations, transoesophageal echocardiography visualised vegetations on the patient's mitral valve, which had previously undergone repair with annuloplasty. The patient was found to have infectious endocarditis (IE), caused by The patient was treated with over 6 weeks of intravenous antibiotics. Cases of -associated IE are rare and largely relegated to case reports. This report aims to contribute to the literature regarding this subject, and to further characterise the presentation and treatment of -associated IE. Additionally, this report emphasises the importance of maintaining a high suspicion of IE in a patient with non-specific malaise in the setting of prior cardiac valve operation.

摘要

一位患有先天性心脏病病史的女性,曾多次接受过二尖瓣修复手术,她因 2 个月的腰背疼痛和全身不适就诊。血液培养结果为革兰阳性球菌阳性。尽管经胸超声心动图未发现赘生物,但经食管超声心动图发现患者先前接受过瓣环成形术修复的二尖瓣上有赘生物。该患者被诊断为感染性心内膜炎(IE),由 引起。该患者接受了超过 6 周的静脉抗生素治疗。与相关的 IE 病例较为罕见,主要为病例报告。本报告旨在为该主题的文献做出贡献,并进一步描述与相关的 IE 的表现和治疗。此外,本报告强调了在先前进行过心脏瓣膜手术的患者出现非特异性不适的情况下,对 IE 保持高度怀疑的重要性。

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