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三尖瓣感染性心内膜炎:一例具有不寻常特征的病例。

Triple-Valve Infective Endocarditis: A Case with Unusual Features.

作者信息

Oliveira Inês, Vasconcelos Gisela, Bragança Bruno, Cruz Margarida, Abreu Glória, Azevedo João, Andrade Aurora

机构信息

Cardiology Department, Centro Hospitalar Tâmega e Sousa, Penafiel, Portugal.

Internal Medicine Department, Centro Hospitalar Tâmega e Sousa, Penafiel, Portugal.

出版信息

Eur J Case Rep Intern Med. 2022 Apr 27;9(4):003350. doi: 10.12890/2022_003350. eCollection 2022.

Abstract

UNLABELLED

Infective endocarditis is a condition associated with high morbidity and mortality, usually with univalvular involvement. We describe the case of a 76-year-old woman with triple-valve endocarditis due to , complicated by perivalvular suppurative lesions, acute heart failure and acute kidney injury. Unfortunately, the patient died despite antibiotic therapy and emergent surgery. This case highlights uncommon triple-valve involvement in the absence of risk factors, posing a diagnostic and therapeutic challenge.

LEARNING POINTS

Native triple-valve endocarditis is extremely rare, especially in the absence of predisposing conditions. has been associated with endocarditis as well colonic and hepatobiliary pathology, so gastrointestinal endoscopy is important as bacteraemia frequently precedes gastrointestinal symptoms, allowing prompt diagnosis.In multivalvular involvement, early surgery is often required, and timely recognition and treatment before complications develop may be decisive for prognosis.

摘要

未标注

感染性心内膜炎是一种与高发病率和死亡率相关的疾病,通常累及单个瓣膜。我们描述了一例76岁女性因[具体病因未提及]导致三尖瓣心内膜炎的病例,并发瓣周化脓性病变、急性心力衰竭和急性肾损伤。不幸的是,尽管进行了抗生素治疗和紧急手术,患者仍死亡。该病例突出了在无危险因素情况下罕见的三尖瓣受累,带来了诊断和治疗挑战。

学习要点

原发性三尖瓣心内膜炎极为罕见,尤其是在没有易感因素的情况下。[具体病因未提及]与心内膜炎以及结肠和肝胆疾病有关,因此胃肠内镜检查很重要,因为菌血症常常先于胃肠道症状出现,可实现早期诊断。在多瓣膜受累时,通常需要早期手术,在并发症发生前及时识别和治疗可能对预后起决定性作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cd22/9067413/5fbec9989339/3350_Fig1.jpg

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