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病例报告:难治性心内膜炎的心脏移植:一例病例报告及文献综述

Case Report: Heart Transplantation for Refractory Endocarditis: A Case Report and Literature Review.

作者信息

El Nouwar Ricardo, Larranaga Lapique Eva, Vanden Eynden Frédéric, Martiny Delphine, Remmelink Myriam, Roussoulières Ana, Hites Maya

机构信息

Clinic of Infectious Diseases, Hôpital Universitaire de Bruxelles (HUB), 1070 Brussels, Belgium.

Department of Cardiac Surgery, Hôpital Universitaire de Bruxelles (HUB), 1070 Brussels, Belgium.

出版信息

Microorganisms. 2025 Mar 4;13(3):580. doi: 10.3390/microorganisms13030580.

DOI:10.3390/microorganisms13030580
PMID:40142472
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11945179/
Abstract

infective endocarditis presents therapeutic challenges with high mortality. A complex case of prosthetic valve endocarditis refractory to standard antifungals (anidulafungin and fluconazole) and high-dose caspofungin was successfully treated with heart transplantation. The literature review revealed a few cases of bacterial endocarditis successfully treated with heart transplantation, but with only two transplanted cases of fungal endocarditis. This report explores heart transplantation as a last resort for managing refractory infective endocarditis. The patient is still alive and free of infection, two and a half years after transplantation.

摘要

感染性心内膜炎带来了治疗挑战,死亡率很高。一例人工瓣膜心内膜炎的复杂病例,对标准抗真菌药物(阿尼芬净和氟康唑)以及高剂量卡泊芬净治疗无效,最终通过心脏移植成功治愈。文献综述显示,有几例细菌性心内膜炎通过心脏移植成功治愈,但真菌性心内膜炎的移植病例仅有两例。本报告探讨了心脏移植作为治疗难治性感染性心内膜炎的最后手段。该患者在移植两年半后仍然存活,且未发生感染。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/25aa/11945179/719b6a88ba6e/microorganisms-13-00580-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/25aa/11945179/5f2593201430/microorganisms-13-00580-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/25aa/11945179/1c1457066fda/microorganisms-13-00580-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/25aa/11945179/719b6a88ba6e/microorganisms-13-00580-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/25aa/11945179/5f2593201430/microorganisms-13-00580-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/25aa/11945179/1c1457066fda/microorganisms-13-00580-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/25aa/11945179/719b6a88ba6e/microorganisms-13-00580-g003.jpg

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本文引用的文献

1
Heart transplantation as salvage treatment of intractable infective endocarditis.心脏移植作为难治性感染性心内膜炎的挽救性治疗手段。
Infect Dis (Lond). 2023 May;55(5):370-374. doi: 10.1080/23744235.2023.2184490. Epub 2023 Mar 3.
2
A complicated course of Salmonella endocarditis leading to heart transplantation.一例导致心脏移植的复杂沙门氏菌性心内膜炎病程。
Kardiol Pol. 2022;80(9):945-946. doi: 10.33963/KP.a2022.0176. Epub 2022 Jul 28.
3
Heart transplantation for end-stage heart failure combined with Q fever isolated to the heart: a case report.
心脏移植治疗终末期心力衰竭合并孤立性心脏Q热:一例报告
Eur Heart J Case Rep. 2020 Dec 5;4(6):1-4. doi: 10.1093/ehjcr/ytaa435. eCollection 2020 Dec.
4
Heart transplantation for recurrent Cutibacterium (Propionibacterium) acnes prosthetic heart valve endocarditis.心脏移植治疗复发性痤疮丙酸杆菌人工心脏瓣膜心内膜炎。
ANZ J Surg. 2021 Jan;91(1-2):196-197. doi: 10.1111/ans.16024. Epub 2020 Jun 3.
5
Salvage heart transplantation for Mycoplasma hominis prosthetic valve endocarditis: A case report and review of the literature.人型支原体人工瓣膜心内膜炎的挽救性心脏移植:一例病例报告及文献复习
Transpl Infect Dis. 2020 Apr;22(2):e13249. doi: 10.1111/tid.13249. Epub 2020 Feb 10.
6
Heart transplantation for infective endocarditis: Viable option for a limited few?感染性心内膜炎的心脏移植:对少数人来说是可行的选择吗?
Transpl Infect Dis. 2019 Feb;21(1):e13006. doi: 10.1111/tid.13006. Epub 2018 Oct 28.
7
Heart transplantation and Candida endocarditis.心脏移植与念珠菌性心内膜炎
Transpl Infect Dis. 2016 Jun;18(3):483-4. doi: 10.1111/tid.12520. Epub 2016 Apr 7.
8
Clinical Practice Guideline for the Management of Candidiasis: 2016 Update by the Infectious Diseases Society of America.《念珠菌病管理临床实践指南:美国传染病学会2016年更新版》
Clin Infect Dis. 2016 Feb 15;62(4):e1-50. doi: 10.1093/cid/civ933. Epub 2015 Dec 16.
9
Antifungal pharmacokinetics and pharmacodynamics.抗真菌药物的药代动力学与药效学
Cold Spring Harb Perspect Med. 2014 Nov 10;5(5):a019653. doi: 10.1101/cshperspect.a019653.
10
Virulence Factors Contributing to Pathogenicity of Candida tropicalis and Its Antifungal Susceptibility Profile.热带假丝酵母菌致病的毒力因子及其抗真菌药敏谱
Int J Microbiol. 2014;2014:456878. doi: 10.1155/2014/456878. Epub 2014 Apr 2.