Saleh Jimmy, Georgiou Stephen, Samimi Mersal, Al-Bayati Asseel, Woodbury Brandon
Internal Medicine, University of California San Francisco, Fresno, USA.
Cardiology, University of California San Francisco, Fresno, USA.
Cureus. 2024 Sep 10;16(9):e69143. doi: 10.7759/cureus.69143. eCollection 2024 Sep.
Infective endocarditis is a potentially life-threatening condition that can have grave cardiac and neurologic complications. Recognizing risk factors, such as the presence of Gram-positive bacteremia and cardiac devices, has improved early recognition and management. The spleen plays an important role in the immune response, helping protect the body from infection from various bacteria. However, there is a paucity of literature regarding post-splenectomy patients with cardiac devices and the risk of endocarditis in this population. We present a case of infective endocarditis as a late sequela post-splenectomy in a 60-year-old patient with a history of a dual-chamber pacemaker. The patient was initially found to have bacteremia after splenectomy with repeat transesophageal echocardiogram confirming a tricuspid vegetation. The patient ultimately required pacemaker extraction and a prolonged course of intravenous cefazolin. The clinical course was complicated by a septic pulmonary embolus.
感染性心内膜炎是一种潜在的危及生命的疾病，可引发严重的心脏和神经并发症。识别危险因素，如革兰氏阳性菌血症和心脏装置的存在，有助于提高早期识别和管理水平。脾脏在免疫反应中发挥重要作用，帮助保护身体免受各种细菌感染。然而，关于脾切除术后植入心脏装置的患者以及该人群发生心内膜炎的风险，相关文献较少。我们报告一例60岁有双腔起搏器病史的患者，脾切除术后发生感染性心内膜炎的迟发性后遗症。患者脾切除术后最初被发现有菌血症，经食管超声心动图复查证实三尖瓣有赘生物。患者最终需要取出起搏器，并接受了长时间的静脉注射头孢唑林治疗。临床过程因脓毒性肺栓塞而复杂化。
