Université de Sousse, Faculté de Médecine de Sousse, 4002, Sousse, Tunisie.
Department of Cardiology Ibn El Jazzar Hospital, 3100, Kairouan, Tunisia.
Pan Afr Med J. 2022 Feb 24;41:165. doi: 10.11604/pamj.2022.41.165.29866. eCollection 2022.
Tunnel sub-aortic stenosis is a very unusual form of obstruction to left ventricular outflow. Endocarditis involving this congenital anomaly is extremely rare and not described in literature. We report the case of a 45-year-old woman who was diagnosed with a severe left ventricle outflow obstruction because of sub-aortic tunnel and was proposed for elective surgery. One month after diagnosis of her heart disease, she presented with fever and deterioration of general condition. Diagnosis of infective endocarditis secondary to a community acquired streptococcus viridans was confirmed on the basis of biological and echocardiographic abnormalities. The evolution was fatal because of multivalvular destruction and severe left ventricle dysfunction, despite rapid surgery and antibiotherapy. In this case report, we describe an extremely rare situation and we insist on the aggressive character of infective endocarditis in sub-aortic tunnel. We also emphasize the importance of antibioprophylaxis in this specific condition.
主动脉下隧道狭窄是一种非常罕见的左心室流出道梗阻形式。涉及这种先天性异常的感染性心内膜炎极为罕见，文献中也没有描述。我们报告了一例 45 岁女性的病例，该患者因主动脉下隧道而被诊断为严重的左心室流出道梗阻，并被提议进行择期手术。在诊断出心脏病一个月后，她出现发热和全身状况恶化。基于生物学和超声心动图异常，诊断为社区获得性草绿色链球菌引起的感染性心内膜炎。尽管进行了快速手术和抗生素治疗，但由于多瓣膜破坏和严重的左心室功能障碍，病情仍进展为致命性。在本病例报告中，我们描述了一种极其罕见的情况，并强调了主动脉下隧道感染性心内膜炎的侵袭性特征。我们还强调了在这种特殊情况下抗生素预防的重要性。
