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从侧腹痛到脾脓肿:一例感染性心内膜炎的复杂病例并文献复习。

From flank pain to splenic abscess: a complex case of infective endocarditis with literature review.

机构信息

Jordan University of Science & Technology, Irbid, Jordan.

Faculty of Medicine, University of Kalamoon, Al-Nabk, Syria.

出版信息

BMC Cardiovasc Disord. 2024 Sep 27;24(1):520. doi: 10.1186/s12872-024-04207-0.

Abstract

BACKGROUND

Infective endocarditis (IE) is a severe condition characterized by inflammation of the heart endocardium and valves, commonly caused by Gram-positive bacteria. Complications such as embolic phenomena and organ abscesses can arise, necessitating timely diagnosis and intervention.

CASE PRESENTATION

We report the case of a 20-year-old female with a history of cerebral and splenic infarctions due to IE. The patient presented with left-sided flank pain, urinary burning, and fever. Examination revealed mitral and aortic valve involvement, splenomegaly, and neurological deficits. Despite initial antibiotic therapy, the patient developed a splenic abscess and drug-induced neutropenia. She required aortic valve replacement and was successfully managed with a multidisciplinary approach.

CONCLUSION

Multidisciplinary management, including timely surgical intervention and advanced imaging, is essential for favorable outcomes in IE patients. This case underscores the importance of early detection and tailored treatment strategies in managing severe complications associated with IE.

摘要

背景

感染性心内膜炎(IE)是一种严重的疾病,其特征为心脏的心内膜和瓣膜发生炎症,通常由革兰阳性菌引起。可能会出现栓塞现象和器官脓肿等并发症,需要及时诊断和干预。

病例介绍

我们报告了一例 20 岁女性因 IE 导致脑梗死和脾梗死的病例。患者出现左侧腰痛、尿痛和发热。检查发现二尖瓣和主动脉瓣受累、脾肿大和神经功能缺损。尽管最初接受了抗生素治疗,但患者出现了脾脓肿和药物诱导性中性粒细胞减少症。她需要主动脉瓣置换术,并通过多学科方法成功治疗。

结论

多学科管理,包括及时的手术干预和先进的影像学检查,对于 IE 患者的良好预后至关重要。该病例强调了早期发现和制定针对 IE 相关严重并发症的治疗策略的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b76/11430165/73afb7dc2f47/12872_2024_4207_Fig1_HTML.jpg

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