Pereira Catarina, Nogueira Fernando, Cunha Marques José, Ferreira José Pestana, Almeida Jorge S
Internal Medicine, Centro Hospitalar e Universitário de São João, Porto, PRT.
Medicine, Faculdade de Medicina da Universidade do Porto (FMUP), Porto, PRT.
Cureus. 2023 Feb 2;15(2):e34529. doi: 10.7759/cureus.34529. eCollection 2023 Feb.
The diagnosis of infective endocarditis is challenging because it has a variable clinical presentation and nonspecific symptoms and can present in different forms, especially when an unusual etiological agent is involved. We present the case of a female in her 70s admitted to the hospital with a medical history of bicytopenia, severe aortic stenosis, and rheumatoid arthritis. She had several consultations during which she presented with asthenia and general malaise. A septic screen test was performed that would determine that was present in a blood culture (BC), which was not valued. About three months later, she was hospitalized. In the first 24 hours of admission, the septic screen test was repeated and was isolated in BC. Splenic infarctions and transthoracic echocardiography suggested probable endocarditis, which was confirmed with transesophageal echocardiography. She underwent surgical intervention to remove the perivalvular abscess and replace the aortic prosthesis.
感染性心内膜炎的诊断具有挑战性，因为其临床表现多样、症状不具特异性，且可呈现不同形式，尤其是在涉及不寻常病原体时。我们报告一例70多岁女性患者，她因双血细胞减少症、严重主动脉瓣狭窄和类风湿关节炎病史入院。她曾多次会诊，期间出现乏力和全身不适。进行了一次败血症筛查试验，结果显示血培养（BC）中有[具体病原体未给出]，但未受到重视。大约三个月后，她再次住院。入院后的头24小时内，重复进行了败血症筛查试验，血培养中分离出[具体病原体未给出]。脾梗死和经胸超声心动图提示可能为心内膜炎，经食管超声心动图证实了这一诊断。她接受了手术干预，以清除瓣周脓肿并更换主动脉假体。
