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真菌性心内膜炎的诊断与治疗挑战:一名血液透析患者复发性念珠菌性心内膜炎的病例报告

Challenges in Diagnosing and Treating Fungal Endocarditis: A Case Report of Recurrent Candida Endocarditis in a Hemodialysis Patient.

作者信息

Almuhammadi Ghaidaa A, Alzughaibi Rawia A, Amer Lamar A, Alzahrani Talal S

机构信息

College of Medicine, Taibah University, Medinah, Saudi Arabia.

Department of Internal Medicine, Taibah University, Medinah, Saudi Arabia.

出版信息

J Saudi Heart Assoc. 2025 Jan 26;37(1):4. doi: 10.37616/2212-5043.1414. eCollection 2025.

Abstract

Fungal endocarditis (FE) is a rare yet life-threatening condition, especially in hemodialysis (HD) patients with indwelling long-term catheters. Symptoms often overlap with non-fungal infective endocarditis, making diagnosis difficult. As FE incidence increases, healthcare providers face challenges in diagnosing and managing this severe condition. Early suspicion of FE is crucial for patients with long-term catheters. We reported a 23-year-old male with end-stage renal disease (ESRD) on HD that developed FE affecting the tricuspid valve, requiring valve replacement and anti-fungal medication. Despite these interventions, he had recurrent Candida prosthetic endocarditis (CPE). Currently, he is receiving anti-fungal medication, with plans for a third surgery.

摘要

真菌性心内膜炎(FE)是一种罕见但危及生命的疾病,尤其是在长期留置导管的血液透析(HD)患者中。其症状常与非真菌性感染性心内膜炎重叠,导致诊断困难。随着FE发病率的上升,医疗服务提供者在诊断和管理这种严重疾病方面面临挑战。对于长期留置导管的患者,早期怀疑FE至关重要。我们报告了一名23岁患有终末期肾病(ESRD)并接受血液透析的男性,他患上了累及三尖瓣的FE,需要进行瓣膜置换和抗真菌治疗。尽管采取了这些干预措施,他仍反复发生念珠菌人工瓣膜心内膜炎(CPE)。目前,他正在接受抗真菌治疗,并计划进行第三次手术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bb00/11839166/4adb4241c848/sha4f1.jpg

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