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由原生主动脉瓣心内膜炎并发主动脉根部脓肿导致多发性脓毒性栓子引起肠缺血和脾梗死的糖尿病酮症酸中毒的罕见有趣病例表现。

A Rare and Interesting Presentation of Diabetic Ketoacidosis Caused by Native Aortic Valve Endocarditis Complicated by Aortic Root Abscess Resulting in Multiple Septic Emboli Causing Bowel Ischemia and Splenic Infarction.

作者信息

Vinod Vijay C, Farhana Umme, Waring Scott, Mlawa Gideon

机构信息

Medicine, Barking, Havering and Redbridge University Hospitals NHS Trust, London, GBR.

Internal Medicine and Diabetes and Endocrinology, Barking, Havering and Redbridge University Hospitals NHS Trust, London, GBR.

出版信息

Cureus. 2022 Sep 17;14(9):e29254. doi: 10.7759/cureus.29254. eCollection 2022 Sep.

Abstract

Diabetic ketoacidosis (DKA) is a serious life-threatening complication of diabetes, often precipitated by infection. Infective endocarditis (IE) is a serious precipitating factor for DKA, especially in patients with a previous cardiac surgery or valvular pathology. IE can be further complicated by life-threatening embolic events, which could be fatal if not detected and managed early and effectively. Our patient is a 54-year-old diabetic who presented with DKA precipitated by native aortic valve endocarditis complicated by an aortic root abscess, which was further complicated by septic emboli to the splenic artery and superior mesenteric artery leading to splenic infarction and bowel ischemia, respectively. To our knowledge and as per the literature reviewed, no case has been reported in a single patient who presented with DKA precipitated by IE complicated by aortic root abscess and multiple septic emboli resulting in bowel ischemia and splenic infarction.

摘要

糖尿病酮症酸中毒(DKA)是糖尿病一种严重的、危及生命的并发症,常由感染诱发。感染性心内膜炎(IE)是DKA的一个严重诱发因素,尤其是在既往有心脏手术或瓣膜病变的患者中。IE可进一步并发危及生命的栓塞事件,如果不及早发现并有效处理,可能会致命。我们的患者是一名54岁的糖尿病患者,因原发性主动脉瓣心内膜炎并发主动脉根部脓肿而引发DKA,进而又因脾动脉和肠系膜上动脉的脓毒性栓子分别导致脾梗死和肠缺血而使病情进一步复杂化。据我们所知,且根据所查阅的文献,尚未有报道称单一患者因IE并发主动脉根部脓肿和多个脓毒性栓子导致肠缺血和脾梗死而引发DKA的病例。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5cc2/9575144/3109823a6b9e/cureus-0014-00000029254-i01.jpg

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