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成功治疗布鲁氏菌感染性心内膜炎致二尖瓣关闭不全 1 例

Successful Surgical Treatment of Mitral Valve Endocarditis Caused by Brucella: A Case Report.

机构信息

Department of Cardiovascular Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, 310020 Hangzhou, Zhejiang, China.

出版信息

Heart Surg Forum. 2023 Aug 9;26(4):E322-E325. doi: 10.59958/hsf.5857.

Abstract

Brucellosis endocarditis is a rare but life-threatening complication of brucellosis, involving congenital, prosthetic and even native valves. Its diagnosis and treatment is a great challenge for doctors. The patient's prognosis requires prompt diagnosis and continuous evaluation of treatment plans to assess the need for either surgical intervention of the infected valves or continuation of antibiotic therapy alone. We present a patient with brucellosis endocarditis, predominantly involving the mitral valve, presenting with vegetations and prolapse of the anterior leaflet of the mitral valve with moderate to severe regurgitation. The patient was treated with triple antibiotic therapy before surgery. After the patient's blood culture results were negative, we removed the infected mitral valve vegetations and performed a mitral valve replacement. The patient was successfully extubated 4 hours after surgery and discharged 11 days after surgery. After discharge, the patient continued to receive triple antibiotic therapy for 2 months and was followed up at the cardiac surgery and infectious disease outpatient clinics.

摘要

布鲁氏菌性心内膜炎是布鲁氏菌病的一种罕见但危及生命的并发症,涉及先天性、人工和甚至天然瓣膜。其诊断和治疗对医生来说是一个巨大的挑战。患者的预后需要及时诊断和持续评估治疗方案,以评估是否需要对受感染的瓣膜进行手术干预,还是仅继续抗生素治疗。我们报告了 1 例以二尖瓣为主的布鲁氏菌性心内膜炎患者,该患者表现为二尖瓣前叶赘生物和脱垂,伴有中度至重度反流。该患者在手术前接受了三联抗生素治疗。在患者的血培养结果转为阴性后,我们切除了感染的二尖瓣赘生物并进行了二尖瓣置换术。患者在手术后 4 小时成功拔管,术后 11 天出院。出院后,患者继续接受三联抗生素治疗 2 个月,并在心脏外科和感染性疾病门诊进行随访。

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