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洋葱伯克霍尔德菌所致的原发性主动脉瓣感染性心内膜炎:一例报告并文献复习

Burkholderia cepacia Infective Endocarditis of Native Aortic Valve: A Case Report and Review of Literature.

作者信息

Almubarak Isa, Almubarak Abdulla J, Ahmed Yusuf A, Ali Manar A, Yusuf Walaa H, Ismail Mariam, Elhadidi Shady, Abdelaziz Hanaa, Gabr Mohamed A, Awad Gehad

机构信息

Department of General Surgery, Al Kindi Hospital, Manama, BHR.

Faculty of Medicine, Mansoura University, Mansoura, EGY.

出版信息

Cureus. 2024 Oct 15;16(10):e71548. doi: 10.7759/cureus.71548. eCollection 2024 Oct.

Abstract

Infective endocarditis (IE) is a serious cardiac infection of the endocardium, native and prosthetic valves, or cardiac device. In this case study, we report a case of an immunocompetent patient with severe aortic valve endocarditis. A 54-year-old female presented to the emergency department with progressive shortness of breath, chest pain, palpitations, and cough for a period of 20 days. On physical examination, the patient was orthopneic, tachypneic, and tachycardic with an irregularly irregular rhythm. Her blood pressure was 110/80, with an oxygen saturation of 88% on room air. On auscultation, variable S1 intensity, weak S2, ejection systolic murmurs all over the precordium, and bilateral crepitations were heard over lung bases. Electrocardiography was performed, which showed atrial fibrillation with rapid ventricular response. Transthoracic echocardiography and transesophageal echocardiography were performed, which revealed a large aortic valve mass causing severe valvular obstruction. Blood culture results were non-conclusive. Autoimmune laboratory workup was conducted to exclude systemic lupus erythematosus and antiphospholipid syndrome. The patient received loop diuretics and empirical antibiotics initially, and an urgent surgical aortic valve replacement was performed. was detected by microbiological analysis of the excised valve. Amoxicillin/clavulanic acid was given for a period of four weeks post-operatively. could be one of the causative organisms causing IE and can affect the aortic valve in immunocompetent patients.

摘要

感染性心内膜炎(IE)是一种严重的心脏内膜感染,可累及自身瓣膜、人工瓣膜或心脏装置。在本病例研究中,我们报告一例免疫功能正常的患者发生严重主动脉瓣心内膜炎的病例。一名54岁女性因进行性气短、胸痛、心悸和咳嗽20天就诊于急诊科。体格检查时,患者端坐呼吸、呼吸急促、心动过速,心律绝对不齐。她的血压为110/80,在室内空气中氧饱和度为88%。听诊时,可闻及第一心音强度可变、第二心音减弱、心前区全收缩期喷射样杂音,双肺底部可闻及双侧湿啰音。进行了心电图检查,显示房颤伴快速心室反应。进行了经胸超声心动图和经食管超声心动图检查,结果显示一个大的主动脉瓣赘生物导致严重的瓣膜梗阻。血培养结果无定论。进行了自身免疫实验室检查以排除系统性红斑狼疮和抗磷脂综合征。患者最初接受了袢利尿剂和经验性抗生素治疗,并紧急进行了主动脉瓣置换手术。通过对切除瓣膜的微生物分析检测到了 。术后给予阿莫西林/克拉维酸治疗四周。 可能是导致IE的病原体之一,可影响免疫功能正常患者的主动脉瓣。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ac6b/11563448/ea0b47848064/cureus-0016-00000071548-i01.jpg

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