Yokochi K, Sakamoto H, Mikajima T, Ichinose E, Kato H, Eto Y
Jpn Circ J. 1986 Dec;50(12):1294-7. doi: 10.1253/jcj.50.1294.
Twenty-three cases of IE, of which 91% had underlying congenital heart diseases were diagnosed by positive blood culture or vegetative lesion detected by 2-D ECHO when a patient revealed clinically suspicious episodes. VSD and TOF were the most common underlying heart diseases. The vegetation was detected successfully by 2-D ECHO in 91% of the cases. The causative organisms were identified in 83% of the cases. Streptococcus viridans and Staphylococcus aureus were the two major organisms detected. Candida albicans was found in 3 postoperative and fatal cases. Embolic complications occurred in 7 cases (30.5%): five cases of pulmonary infarction and two of cerebral infarction. The overall mortality was 22%. We recommend early surgical intervention whenever a patient reveals a very large vegetation with animated movability, and emphasize the importance of a proper prophylaxic regimen.
23例感染性心内膜炎（IE）患者中，91%有潜在先天性心脏病，当患者出现临床可疑症状时，通过血培养阳性或二维超声心动图（2-D ECHO）检测到赘生物病变得以确诊。室间隔缺损（VSD）和法洛四联症（TOF）是最常见的潜在心脏病。二维超声心动图在91%的病例中成功检测到赘生物。83%的病例中确定了致病微生物。草绿色链球菌和金黄色葡萄球菌是检测到的两种主要微生物。在3例术后及死亡病例中发现白色念珠菌。7例（30.5%）发生栓塞并发症：5例肺梗死，2例脑梗死。总死亡率为22%。我们建议，一旦患者出现具有活跃可动性的非常大的赘生物，应尽早进行手术干预，并强调适当预防方案的重要性。
