Pradhan Rebicca, Shrestha Bibek, Dahal Agnimshwor
Department of Cardiology Dhaka Medical College Hospital, University of Dhaka Dhaka Bangladesh.
Institute of Medicine Maharajgunj Medical Campus, Tribhuvan University Maharajgunj Nepal.
Clin Case Rep. 2024 Nov 29;12(12):e9651. doi: 10.1002/ccr3.9651. eCollection 2024 Dec.
The case report examines a rare presentation of tricuspid valve infective endocarditis (TVIE) following a septic abortion. A 31-year-old female presented with persistent high-grade fever, chills, and mild vaginal bleeding post medical termination of pregnancy. Despite initial management for septic abortion, including manual evacuation and antibiotics, her symptoms recurred, necessitating further evaluation. Diagnostic workup revealed methicillin-resistant (MRSA) bacteremia and echocardiographic evidence of vegetations on the tricuspid valve. Treatment included targeted intravenous antibiotics and supportive care, but due to family preference, the patient was referred for advanced management. The report underscores the importance of considering endocarditis in patients with unresolved infections post-gynecological procedures. It highlights the role of blood cultures and echocardiography in diagnosis and emphasizes prophylactic measures and sterile techniques to prevent such complications. This case exemplifies a critical need for prompt multidisciplinary interventions to mitigate morbidity associated with rare but severe sequelae of septic abortion.
该病例报告探讨了一例败血症性流产后罕见的三尖瓣感染性心内膜炎（TVIE）病例。一名31岁女性在药物流产后出现持续高热、寒战和轻度阴道出血。尽管最初对败血症性流产进行了处理，包括人工清宫和使用抗生素，但她的症状仍反复出现，需要进一步评估。诊断检查发现耐甲氧西林金黄色葡萄球菌（MRSA）菌血症以及三尖瓣上有赘生物的超声心动图证据。治疗包括针对性的静脉用抗生素和支持治疗，但由于患者家属的选择，该患者被转至上级医疗机构进一步治疗。该报告强调了在妇科手术后仍有未解决感染的患者中考虑心内膜炎的重要性。它突出了血培养和超声心动图在诊断中的作用，并强调了预防措施和无菌技术以防止此类并发症。该病例表明迫切需要迅速采取多学科干预措施，以减轻与败血症性流产罕见但严重后遗症相关的发病率。
