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社区获得性耐甲氧西林金黄色葡萄球菌所致原发性主动脉瓣感染性心内膜炎:一例报告及文献复习

Native Aortic Valve Infective Endocarditis Secondary to Community-Acquired Methicillin-Resistant Staphylococcus aureus: A Case Report and Literature Review.

作者信息

Awlad Thani Saif, Al Jamei Shahd M, Al Azri Kadhiya N, Al Alawi Khalid, Al Shabibi Saud

机构信息

Pediatric Critical Care, The Royal Hospital, Muscat, OMN.

Pediatrics, Oman Medical Specialty Board, Muscat, OMN.

出版信息

Cureus. 2024 Mar 1;16(3):e55341. doi: 10.7759/cureus.55341. eCollection 2024 Mar.

Abstract

Infective endocarditis (IE) refers to a microbial infection affecting either a heart valve or endocardium, resulting in tissue damage and the formation of vegetation. Native aortic valve endocarditis in children is rare and is associated with serious complications related to valvular insufficiency and systemic embolizations. As reports about community-acquired methicillin-resistant (MRSA) native aortic valve endocarditis in children are very scarce, we report this case along with a literature review about its complications and management. Here, we report the case of a seven-month-old infant who was previously healthy and presented with signs and symptoms of shock and systemic embolizations secondary to native aortic valve IE. His blood culture showed MRSA. He developed aortic valve insufficiency heart failure and multiorgan septic emboli that progressed to fatal refractory multiorgan failure. The management of complicated aortic valve endocarditis in children is challenging and needs a multidisciplinary team approach and prompt intervention.

摘要

感染性心内膜炎(IE)是指微生物感染累及心脏瓣膜或心内膜,导致组织损伤并形成赘生物。儿童原发性主动脉瓣心内膜炎较为罕见,且与瓣膜关闭不全和系统性栓塞相关的严重并发症有关。由于关于儿童社区获得性耐甲氧西林金黄色葡萄球菌(MRSA)原发性主动脉瓣心内膜炎的报道非常稀少,我们报告此病例并对其并发症及管理进行文献综述。在此,我们报告一例7个月大的婴儿,该婴儿此前健康,因原发性主动脉瓣感染性心内膜炎出现休克及系统性栓塞的症状和体征。其血培养显示为MRSA。他发展为主动脉瓣关闭不全、心力衰竭及多器官脓毒性栓子,最终进展为致命的难治性多器官衰竭。儿童复杂性主动脉瓣心内膜炎的管理具有挑战性,需要多学科团队协作及及时干预。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2a5d/10981920/f18673a3718f/cureus-0016-00000055341-i01.jpg

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