Henan Integrative Medicine Hospital, Zhengzhou, 450004, China.
Henan Province Hospital of TCM, Zhengzhou, 450003, China.
BMC Neurol. 2024 Oct 4;24(1):372. doi: 10.1186/s12883-024-03870-2.
Infectious endocarditis (IE) is an infectious disease caused by direct invasion of the heart valve, endocardium, or adjacent large artery endocardium by pathogenic microorganisms. Despite its relatively low incidence, it has a poor prognosis and a high mortality. Intracranial infectious aneurysms (IIA) and ruptured sinus of Valsalva aneurysm (RSVA) are rare complications of IE.
We report a young male patient with symptoms of respiratory tract infection, heart murmurs and other symptoms and signs. The patient also had kidney function impairment and poor response to symptomatic therapy. Blood culture was negative, but echocardiography was positive, which met the diagnostic criteria for infective endocarditis. Moreover, an echocardiography showed a ruptured sinus of Valsalva aneurysm with a ventricular septal defect. Finally, secondary rupture of an IIA with multiple organ damage led to a poor clinical outcome.
Therefore, in the clinical setting, for young patients with unexplained fever, chest pain, or palpitations, we need to be highly vigilant, considering the possibility of infective endocarditis and promptly performing blood culture, echocardiography, cerebrovascular imaging and so on, in order to facilitate early proper diagnosis and treatment.
感染性心内膜炎(IE)是一种由致病微生物直接侵袭心脏瓣膜、心内膜或临近大动脉内膜引起的感染性疾病。尽管其发病率相对较低,但预后较差,死亡率较高。颅内感染性动脉瘤(IIA)和窦瘤破裂(RSVA)是 IE 的罕见并发症。
我们报告了一例年轻男性患者,有呼吸道感染症状、心脏杂音等症状和体征。该患者还存在肾功能损害,对症状治疗反应不佳。血培养阴性,但超声心动图阳性,符合感染性心内膜炎的诊断标准。此外,超声心动图显示窦瘤破裂合并室间隔缺损。最终,IIA 二次破裂导致多器官损伤,导致临床预后不良。
因此,在临床实践中,对于不明原因发热、胸痛或心悸的年轻患者,我们需要高度警惕,考虑感染性心内膜炎的可能性,并及时进行血培养、超声心动图、脑血管成像等检查,以方便早期进行适当的诊断和治疗。