Ravishankar Ramanish, Hussain Azar, Loubani Mahmoud, Chaudhry Mubarak
Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK.
Department of Cardiothoracic Surgery, Castle Hill Hospital, Hull, UK.
J Surg Case Rep. 2023 Aug 8;2023(8):rjad441. doi: 10.1093/jscr/rjad441. eCollection 2023 Aug.
A 37-year-old pregnant patient presented with symptoms of shortness of breath, cough and malaise at 36 weeks' gestation. Antibiotics were started because of suspected bilateral pneumonia. A lower segment caesarean section was undertaken and significant desaturation lead to intubation of the patient. A CTPA confirmed bilateral pneumonia but also elements of heart failure with a 32 mm dilated pulmonary artery. Severe mitral regurgitation was confirmed with trans-thoracic and trans-oesophageal echocardiogram on Day 5 and emergency mitral valve repair was undertaken for possible infective endocarditis (IE) as per the modified Duke criteria, which was confirmed intra-operatively. The patient completed 4 weeks of antibiotics and suffered mild memory impairment post-operatively. She was discharged from complex rehabilitation after 6 weeks of hospital stay at her baseline state. This case presents IE in a pregnant patient with no significant risk factors with successful recovery because of prompt diagnosis and management.
一名37岁的孕妇在妊娠36周时出现呼吸急促、咳嗽和不适症状。因怀疑双侧肺炎开始使用抗生素。进行了下段剖宫产，严重的血氧饱和度下降导致患者插管。CTPA证实双侧肺炎，但也存在心力衰竭迹象，肺动脉扩张至32毫米。第5天经胸和经食管超声心动图证实存在严重二尖瓣反流，根据改良的杜克标准，因可能的感染性心内膜炎（IE）进行了急诊二尖瓣修复，术中得到证实。患者完成了4周的抗生素治疗，术后出现轻度记忆障碍。住院6周后，她以基线状态从综合康复病房出院。该病例展示了一名无明显危险因素的孕妇发生IE，由于诊断和治疗及时而成功康复。
