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菌血症的罕见表现:主动脉瓣心内膜炎病例研究

Uncommon presentation of bacteremia: A case study on aortic valve endocarditis.

作者信息

Dhapa Nasrin, Rodriguez Hannah, Visinoni Zachary, Misra Neeladri, Lingam Diwakar

机构信息

Department of Graduate Medical Education, Internal Medicine Residency Program, Sutter Roseville Medical Center, Roseville, CA, USA.

Roseville Cardiology Medical Associates, Roseville, CA, USA.

出版信息

SAGE Open Med Case Rep. 2024 Dec 11;12:2050313X241306239. doi: 10.1177/2050313X241306239. eCollection 2024.

Abstract

, a HACEK organism, is one of five species known to less commonly cause infective endocarditis. This article presents a rare and noteworthy case of endocarditis affecting the aortic valve, seemingly unique when species in endocarditis were previously known to more commonly involve the pulmonic or mitral valves. In the setting of bacteremia, a 61-year-old male with no significant past medical history exhibited subtle systemic symptoms with a paucity of clinical signs associated with endocarditis and no evidence of embolic disease. A thorough workup demonstrated a large vegetation involving the aortic valve causing acute aortic insufficiency necessitating subsequent replacement of the aortic valve. In follow-up appointments with providers, the patient demonstrated excellent recovery returning to his baseline activity within 6 months. This case highlights the importance of considering endocarditis in bacteremia, especially in those with an unclear source of infection. Recognition of these rare presentations can assist with timely diagnosis and appropriate management, thus improving patient outcomes.

摘要

一种HACEK菌群,是已知较少引起感染性心内膜炎的五种物种之一。本文介绍了一例罕见且值得注意的影响主动脉瓣的心内膜炎病例,当该物种的心内膜炎以前已知更常累及肺动脉瓣或二尖瓣时,此病例似乎独一无二。在菌血症的情况下,一名61岁无重大既往病史的男性表现出轻微的全身症状,与心内膜炎相关的临床体征较少,且无栓塞性疾病的证据。全面检查显示一个大的赘生物累及主动脉瓣,导致急性主动脉瓣关闭不全,随后需要更换主动脉瓣。在与医疗服务提供者的随访预约中,患者恢复良好,在6个月内恢复到基线活动水平。该病例强调了在菌血症中考虑心内膜炎的重要性,特别是在那些感染源不明的患者中。认识到这些罕见的表现有助于及时诊断和适当管理,从而改善患者的预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/63b2/11632864/9c99c140c36f/10.1177_2050313X241306239-fig1.jpg

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