High Daniel P, Acosta-Rullan Jose M, Herrera Danay, Danckers Mauricio, Heller Daniel, Zapata Daniel
HCA Florida Aventura Hospital, Department of Pulmonary and Critical Care Medicine, Aventura, Florida.
HCA Florida Aventura Hospital, Department of Internal Medicine, Aventura, Florida.
Clin Pract Cases Emerg Med. 2024 May;8(2):155-158. doi: 10.5811/cpcem.1399.
Spontaneous splenic rupture is an extremely rare complication of infective endocarditis.
We present a case of a 56-year-old immunocompetent female with porcine bioprosthetic mitral valve replacement, automated implanted cardioverter-defibrillator, and atrial fibrillation on apixaban who was found to have in-hospital atraumatic splenic rupture complicating infective endocarditis with The rupture was treated successfully by endovascular embolization. Usual treatment with six weeks of antibiotics provided durable cure without further complication, and no surgical intervention was needed for either the valve or spleen.
Transcatheter arterial embolization should be considered early in atraumatic splenic rupture. Relevant abdominal and cerebral imaging should be considered in all cases of suspected or confirmed infective endocarditis where unexplained symptoms are present.
自发性脾破裂是感染性心内膜炎极为罕见的并发症。
我们报告一例56岁免疫功能正常的女性病例，该患者接受了猪生物瓣二尖瓣置换术、植入式自动心脏复律除颤器，正在服用阿哌沙班治疗房颤，住院期间被发现发生了无创伤性脾破裂，并发感染性心内膜炎。通过血管内栓塞成功治疗了脾破裂。常规使用六周抗生素治疗实现了持久治愈，无进一步并发症，瓣膜或脾脏均无需手术干预。
对于无创伤性脾破裂应尽早考虑经导管动脉栓塞治疗。在所有疑似或确诊感染性心内膜炎且出现无法解释症状的病例中，均应考虑进行相关的腹部和脑部影像学检查。
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