Naeem Azka, Kansakar Sajog, Basnet Arjun, Naeem Muzamil, Sharma Neha, Paul Saunders, Khan Muhammad H
Internal Medicine, Maimonides Medical Center, New York, USA.
General Surgery, King Edward Medical University, Lahore, PAK.
Cureus. 2024 Jun 14;16(6):e62373. doi: 10.7759/cureus.62373. eCollection 2024 Jun.
Infective endocarditis (IE) is a rare but serious infection of the cardiac endothelium. This case report presents a rare instance of left-sided endocarditis in an immunocompetent patient without traditional risk factors for IE. endocarditis is uncommon and usually associated with specific factors. The patient in this case was a 30-year-old male with end-stage renal disease, receiving hemodialysis through a tunneled dialysis catheter, who developed a fever. Blood cultures confirmed as the causative agent, which prompted the administration of appropriate antibiotics and the removal of the catheter. However, subsequent imaging revealed significant damage to the mitral valve. Despite timely mitral valve replacement and aggressive medical treatment, the patient's condition worsened, and he ultimately succumbed to the infection. This case also emphasizes the necessity of timely diagnosis and intervention. In this patient, by the time it was diagnosed and managed, significant mitral valve damage had already occurred. Therefore, it should be considered a differential diagnosis even in patients with no risk factors and should be managed vigorously. endocarditis is associated with high mortality, and successful treatment often requires a combination of antipseudomonal antibiotics due to the organism's ability to develop resistance. Surgical intervention, such as valve replacement, is frequently necessary. This case underscores the importance of considering infection, even in patients without traditional risk factors for IE. Early diagnosis, appropriate antibiotic therapy, and timely surgical intervention are critical for improving outcomes in endocarditis cases.
感染性心内膜炎(IE)是一种罕见但严重的心脏内皮感染。本病例报告呈现了一例罕见的免疫功能正常患者左侧心内膜炎,该患者无IE的传统危险因素。心内膜炎并不常见,通常与特定因素相关。本病例中的患者是一名30岁患有终末期肾病的男性,通过隧道式透析导管进行血液透析,他出现了发热症状。血培养确诊 为病原体,这促使给予适当的抗生素并拔除导管。然而,随后的影像学检查显示二尖瓣有严重损伤。尽管及时进行了二尖瓣置换和积极的药物治疗,患者的病情仍恶化,最终死于感染。该病例还强调了及时诊断和干预的必要性。在该患者中,在确诊和处理时,二尖瓣已经发生了严重损伤。因此,即使在无危险因素的患者中也应考虑鉴别诊断,并应积极处理。心内膜炎与高死亡率相关,由于该病原体具有产生耐药性的能力,成功治疗通常需要联合使用抗假单胞菌抗生素。手术干预,如瓣膜置换,通常是必要的。本病例强调了即使在无IE传统危险因素的患者中考虑 感染的重要性。早期诊断、适当的抗生素治疗和及时的手术干预对于改善IE病例的预后至关重要。