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一名9岁男孩患动脉导管未闭合并肺动脉内膜炎致肺梗死:病例报告

Patent ductus arteriosus with pulmonary endarteritis leading to pulmonary infarction in a 9-year-old boy: a case report.

作者信息

Shakya Amshu, Shakya Urmila, Shah Subash Chandra, Bhandari Kc Vidhata, Khadka Devaki, Ghulu Urusha

机构信息

Department of Pediatric Cardiology, Shahid Gangalal National Heart Center, Bansbari, Kathmandu 44600, Nepal.

出版信息

Oxf Med Case Reports. 2024 Nov 20;2024(11):omae132. doi: 10.1093/omcr/omae132. eCollection 2024 Nov.

Abstract

BACKGROUND

Pulmonary endarteritis secondary to Patent ductus arteriosus (PDA) can present even in silent PDAs. Pulmonary endarteritis is treated with prolonged duration of antibiotics followed by PDA closure. It can also cause septic pulmonary emboli requiring critical care if multi-organ dysfunction ensues.

CASE PRESENTATION

A 9-year-old boy had high grade fever for one week and few nonspecific complaints. Echocardiogram showed PDA with infective endarteritis. Child was admitted with IV antibiotics. CECT chest done for resurgence of fever and need for increased oxygen demand showed multiple septic pulmonary emboli with pulmonary infarction. Surgical closure of PDA prevented further clinical deterioration.

CONCLUSION

This case highlights the poor medical scenario of rural communities of Nepal. Such life- threatening complication can be prevented by timely recognition of the condition which is only possible by implementation of standard, accessible and affordable health care system across the country.

摘要

背景

动脉导管未闭(PDA)继发的肺动脉内膜炎即使在无症状的PDA中也可能出现。肺动脉内膜炎采用延长抗生素使用时间随后关闭PDA进行治疗。如果发生多器官功能障碍,它还可导致感染性肺栓塞,需要重症监护。

病例介绍

一名9岁男孩持续高热一周,有一些非特异性症状。超声心动图显示PDA合并感染性动脉内膜炎。患儿因静脉使用抗生素入院。因发热复发及氧需求增加进行的胸部CT血管造影(CECT)显示多发感染性肺栓塞伴肺梗死。PDA手术关闭防止了临床状况进一步恶化。

结论

该病例凸显了尼泊尔农村社区糟糕的医疗状况。通过及时识别病情可预防这种危及生命的并发症,而这只有通过在全国实施标准、可及且负担得起的医疗保健系统才有可能实现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5d8b/11576546/484d9e927bb7/omae132f1.jpg

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