Istrail Larry
Hospital Medicine, Inova Fairfax Hospital, Falls Church, USA.
Cureus. 2023 Mar 12;15(3):e36043. doi: 10.7759/cureus.36043. eCollection 2023 Mar.
Acute bacterial endocarditis is an acute febrile illness that spreads hematogenously and can be fatal if it is not treated in a timely fashion. A traditional physical examination has very limited sensitivity and specificity when diagnosing bacterial endocarditis. Point-of-care ultrasound (POCUS) during the physical exam can assist with the diagnosis by evaluating for valvular regurgitation or visible vegetation. In this case, a patient presented to the hospital with a cough and shortness of breath and was diagnosed with pneumonia. She did not improve with intravenous antibiotics and a POCUS exam revealed the diagnosis was in fact bacterial endocarditis and not pneumonia. This led to further imaging, which revealed an abdominal abscess. This highlights the importance of incorporating POCUS into the physical exam of any patient presenting with cardiopulmonary symptoms.
急性细菌性心内膜炎是一种急性发热性疾病，通过血液传播，如果不及时治疗可能会致命。传统体格检查在诊断细菌性心内膜炎时，敏感性和特异性非常有限。体格检查期间的即时超声检查（POCUS）可通过评估瓣膜反流或可见的赘生物来辅助诊断。在本病例中，一名患者因咳嗽和呼吸急促入院，最初被诊断为肺炎。静脉使用抗生素后病情未改善，POCUS检查显示诊断实际上是细菌性心内膜炎而非肺炎。这促使进一步检查，结果发现了一个腹部脓肿。这凸显了在对任何有心肺症状的患者进行体格检查时纳入POCUS的重要性。
