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一名患有肥厚性梗阻性心肌病的年轻患者感染性心内膜炎的复杂性:双瓣膜受累及神经并发症病例

Complexities of Infective Endocarditis in a Young Patient With Hypertrophic Obstructive Cardiomyopathy: A Case of Dual Valve Involvement and Neurological Complications.

作者信息

Yetiskul Ekrem, Hussain Mohammad M, Khan Danyal F, Khan Salman, Spagnola Jonathan

机构信息

Internal Medicine, Staten Island University Hospital, Staten Island, USA.

Engineering, Stevens Institute of Technology, New York, USA.

出版信息

Cureus. 2024 Apr 2;16(4):e57437. doi: 10.7759/cureus.57437. eCollection 2024 Apr.

Abstract

Infective endocarditis (IE) is a life-threatening infection predominantly affecting the endocardium and heart valves, commonly seen in older patients and those with pre-existing cardiac conditions. Although rare in younger individuals with intact cardiac valves, certain structural heart diseases such as hypertrophic obstructive cardiomyopathy (HOCM) can increase the risk. We present a unique case of a 39-year-old female with a known history of HOCM, a condition characterized by abnormally thickened cardiac muscle primarily affecting the left ventricle. This patient was diagnosed with group B streptococcus infective endocarditis. Notably, this case was complicated by septic emboli to the brain. This case underscores the significant risk of IE in patients with HOCM, a demographic usually less susceptible to IE. It underscores the importance of early recognition and aggressive management of IE, especially in patients with structural heart diseases.

摘要

感染性心内膜炎(IE)是一种危及生命的感染,主要影响心内膜和心脏瓣膜,常见于老年患者及已有心脏疾病的患者。虽然在心脏瓣膜正常的年轻个体中罕见,但某些结构性心脏病,如肥厚型梗阻性心肌病(HOCM)会增加患病风险。我们报告一例独特病例,患者为一名39岁女性,有HOCM病史,该病特征为心肌异常增厚,主要影响左心室。该患者被诊断为B组链球菌感染性心内膜炎。值得注意的是,该病例并发脑脓毒性栓塞。此病例强调了HOCM患者发生IE的重大风险,而这一人群通常对IE不太易感。它强调了早期识别和积极治疗IE的重要性,尤其是在患有结构性心脏病的患者中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/29e4/11063810/4deac6a7df1a/cureus-0016-00000057437-i01.jpg

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