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.
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.
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。
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