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曲霉性心内膜炎。

Aspergillus endocarditis.

机构信息

Department of Cardiovascular & Thoracic Surgery, Amrita Institute of Medical Sciences and Research Center, Amrita Vishwa Vidyapeetham (Amrita University), Kochi, India.

Division of Infectious Diseases, Amrita Institute of Medical Sciences and Research Center, Amrita Vishwa Vidyapeetham (Amrita University), Kochi, India.

出版信息

Indian Heart J. 2024 Jul-Aug;76(4):240-246. doi: 10.1016/j.ihj.2024.08.003. Epub 2024 Aug 22.

DOI:10.1016/j.ihj.2024.08.003
PMID:39179154
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11451410/
Abstract

Aspergillus endocarditis is a rare cause of fungal endocarditis caused by the hyaline mold Aspergillus. The disease most commonly occurs in persons who are immunosuppressed and has a high mortality. Clinical presentation is often with long standing fever, embolic manifestations, and often heart murmurs. Diagnosis of aspergillus endocarditis is often delayed due to the low propensity for Aspergillus to grow in blood culture. Aspergillus endocarditis is characterized by large vegetations and also by frequently being found on the walls of the heart and not on the valves and hence can be missed if not carefully looked for. Definitive diagnosis is often by a combination of microbiological culture and histopathological examination of obtained tissue. Ancillary serological tests like galactomannan assay and polymerase chain reaction also help in the diagnosis. Treatment of aspergillus endocarditis virtually always requires a combination of prolonged antifungal therapy and surgery to enable a cure for these patients.

摘要

曲霉菌心内膜炎是一种罕见的真菌性心内膜炎，由透明丝孢霉属的霉菌引起。这种疾病最常发生于免疫抑制的人群，死亡率很高。临床表现常为长期发热、栓塞表现，且常伴有心脏杂音。由于曲霉菌在血液培养中的生长倾向较低，因此曲霉菌心内膜炎的诊断常常被延误。曲霉菌心内膜炎的特征是大的赘生物，而且常常位于心脏壁上，而不是瓣膜上，如果不仔细观察，可能会被遗漏。明确的诊断通常是通过微生物培养和获得的组织的组织病理学检查的组合来确定的。辅助血清学检测，如半乳甘露聚糖检测和聚合酶链反应，也有助于诊断。曲霉菌心内膜炎的治疗几乎总是需要长期抗真菌治疗和手术的联合治疗，以使这些患者得到治愈。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a1a/11451410/ec53b231f0d7/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a1a/11451410/412445079bd0/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a1a/11451410/9193dc54325c/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a1a/11451410/ec53b231f0d7/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a1a/11451410/412445079bd0/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a1a/11451410/9193dc54325c/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a1a/11451410/ec53b231f0d7/gr3.jpg

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Mitral Valve Aspergillus Endocarditis With Aortal Embolization in an Immunocompetent Patient.免疫功能正常患者的二尖瓣曲霉菌心内膜炎伴主动脉栓塞
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本文引用的文献

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The 2023 Duke-International Society for Cardiovascular Infectious Diseases Criteria for Infective Endocarditis: Updating the Modified Duke Criteria.2023 年杜克-国际心血管感染性疾病学会感染性心内膜炎标准：修改后的杜克标准更新。
Clin Infect Dis. 2023 Aug 22;77(4):518-526. doi: 10.1093/cid/ciad271.
2
Next-Generation Sequencing Applications for the Study of Fungal Pathogens.用于真菌病原体研究的下一代测序应用
Microorganisms. 2022 Sep 21;10(10):1882. doi: 10.3390/microorganisms10101882.
3
Multiple mural endocarditis in the setting of COVID-19.
新型冠状病毒肺炎（COVID-19）背景下的多发性壁性心内膜炎
Eur Heart J Cardiovasc Imaging. 2022 Mar 22;23(4):e168. doi: 10.1093/ehjci/jeac007.
4
Aspergillus endocarditis in the recent years, report of cases of a multicentric national cohort and literature review.近年来的曲霉菌心内膜炎，多中心全国队列病例报告和文献复习。
Mycoses. 2022 Mar;65(3):362-373. doi: 10.1111/myc.13415. Epub 2022 Jan 12.
5
Clinical features, diagnosis and treatment outcome of fungal endocarditis: A systematic review of reported cases.真菌性心内膜炎的临床特征、诊断和治疗结果：系统综述报道病例。
Mycoses. 2022 Mar;65(3):294-302. doi: 10.1111/myc.13398. Epub 2021 Dec 3.
6
Aspergillus Infections.曲霉感染
N Engl J Med. 2021 Oct 14;385(16):1496-1509. doi: 10.1056/NEJMra2027424.
7
Revision and Update of the Consensus Definitions of Invasive Fungal Disease From the European Organization for Research and Treatment of Cancer and the Mycoses Study Group Education and Research Consortium.侵袭性真菌病的共识定义修订与更新：来自欧洲癌症研究与治疗组织和真菌病研究组教育与研究联合会。
Clin Infect Dis. 2020 Sep 12;71(6):1367-1376. doi: 10.1093/cid/ciz1008.
8
Burden of hospitalizations over time with invasive aspergillosis in the United States, 2004-2013.2004-2013 年美国侵袭性曲霉菌病住院负担的时间变化。
BMC Public Health. 2019 May 17;19(1):591. doi: 10.1186/s12889-019-6932-9.
9
The usefulness of cardiac CT in the diagnosis of perivalvular complications in patients with infective endocarditis.心脏 CT 在诊断感染性心内膜炎患者瓣周并发症中的作用。
Eur Radiol. 2019 Aug;29(8):4368-4376. doi: 10.1007/s00330-018-5965-2. Epub 2019 Jan 14.
10
Aspergillus endocarditis: Diagnostic criteria and predictors of outcome, A retrospective cohort study.曲霉性心内膜炎：诊断标准和预后预测因素，一项回顾性队列研究。
PLoS One. 2018 Aug 9;13(8):e0201459. doi: 10.1371/journal.pone.0201459. eCollection 2018.