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感染性心内膜炎及其并发症的发病机制、诊断、抗菌治疗与管理

Pathogenesis, Diagnosis, Antimicrobial Therapy, and Management of Infective Endocarditis, and Its Complications.

作者信息

Kamde Saakshi P, Anjankar Anil

机构信息

Pathology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, IND.

Forensic Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, IND.

出版信息

Cureus. 2022 Sep 15;14(9):e29182. doi: 10.7759/cureus.29182. eCollection 2022 Sep.

Abstract

Infective endocarditis in the adult is life-threatening. Bacterial endocarditis is an inner infection lining the heart muscle (endocardium). The scientific study of the causes of diseases is known as etiology. The agents that cause disease fall into five groups: bacteria, viruses, protozoa, fungi, and helminths (worms). Risk factors are past heart defects, damaged or abnormal heart valves, new valves after surgery, chronic hemodialysis, and immunosuppressed state (chemotherapy, HIV, etc.). Infective endocarditis is categorized into two clinical forms: bacterial acute and subacute endocarditis. Acute bacterial endocarditis is usually caused by and . And occasionally by  and  bacterial strains. Invasive medical technology has increased the responsibility of healthcare-associated infective endocarditis (HAIE). Microscopy of the disease is the chronic aggressive cells in the deeper zone of nonspecific, composed of fibrin and platelets covering colonies of bacteria. Tuberculous valvular endocarditis due to mycobacterium tuberculosis is a rare clinical entity. Syphilitic endocarditis is pathologically the cutaneous lesions of secondary syphilis. It is caused by infection with the microorganism. Fungal endocarditis is a rare and fatal condition. They are infected with fungi such as , and  species. Fatal endocarditis associated with Q fever (query fever). Q fever is a chronic or prolonged disease caused by the -like , a rare form of in the endocarditis. Varicella-zoster virus (VZV) infection causes chronic and repeated febrile illness. They are followed by pharyngitis, malaise, and a vesicular rash. Chronic Q fever usually manifests as endocarditis or hepatitis. The therapy given to simplify the complications is antimicrobial therapy. The medicines prescribed are ampicillin, cefazolin, ceftazidime, gentamicin, vancomycin, metronidazole, and tobramycin. High medicinal antibiotics are used to control the spread of infective endocarditis.

摘要

成人感染性心内膜炎会危及生命。细菌性心内膜炎是心肌内层(心内膜)的一种感染。对疾病病因的科学研究称为病因学。致病因子分为五类:细菌、病毒、原生动物、真菌和蠕虫。危险因素包括既往心脏缺陷、心脏瓣膜受损或异常、手术后的新瓣膜、慢性血液透析以及免疫抑制状态(化疗、艾滋病毒等)。感染性心内膜炎分为两种临床类型:细菌性急性和亚急性心内膜炎。急性细菌性心内膜炎通常由……和……引起。偶尔也由……和……菌株引起。侵入性医疗技术增加了医疗相关感染性心内膜炎(HAIE)的发生几率。该病的显微镜检查显示,在非特异性更深区域有慢性侵袭性细胞,由覆盖细菌菌落的纤维蛋白和血小板组成。由结核分枝杆菌引起的结核性瓣膜心内膜炎是一种罕见的临床病症。梅毒性心内膜炎在病理上是二期梅毒的皮肤病变。它是由微生物感染引起的。真菌性心内膜炎是一种罕见且致命的病症。它们感染了诸如……、……和……等真菌种类。与Q热相关的致命性心内膜炎(疑问热)。Q热是一种由……样……引起的慢性或持续性疾病,是心内膜炎中一种罕见的形式。水痘带状疱疹病毒(VZV)感染会导致慢性反复发热性疾病。随后会出现咽炎、不适和水疱性皮疹。慢性Q热通常表现为心内膜炎或肝炎。为简化并发症而进行的治疗是抗菌治疗。所开的药物有氨苄西林、头孢唑林、头孢他啶、庆大霉素、万古霉素、甲硝唑和妥布霉素。使用高剂量的抗生素来控制感染性心内膜炎的扩散。

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