一名接受慢性血液透析的患者因再次感染出现复发性孤立性肺动脉瓣感染性心内膜炎：首例病例描述及管理考量
Recurrent isolated pulmonic valve infective endocarditis in a patient on chronic haemodialysis due to reinfection: description of an index case and management considerations.
作者信息
Yonghang Sapana, Karn Mitesh, Prado Ana Maritza Marulanda, Cohen Ronny
机构信息
NYC Health and Hospitals/Woodhull, 760 Broadway, Brooklyn, NY 11206, USA.
Department of Medicine, Gandaki Medical College Teaching Hospital, Pokhara 33700, Nepal.
出版信息
Eur Heart J Case Rep. 2025 Mar 24;9(4):ytaf138. doi: 10.1093/ehjcr/ytaf138. eCollection 2025 Apr.
BACKGROUND
Right-sided infective endocarditis is uncommon, and isolated pulmonic valve infective endocarditis (PVIE) is rare. Chronic haemodialysis is a risk factor for developing infective endocarditis. but recurrent PVIE in this population is not well described.
CASE SUMMARY
A 32-year-old male with end-stage renal disease on chronic haemodialysis and diagnosed with PVIE 6 months back due to without identified source of infection presented again with recurrent PVIE with methicillin sensitive , new pulmonic septic emboli, and peri-graft fluid collection on imaging, which was explanted with negative follow-up culture.
DISCUSSION
Through this index case, we describe the unique pathology of recurrent isolated PVIE and explore its diagnostic and management considerations.
背景
右侧感染性心内膜炎并不常见，孤立性肺动脉瓣感染性心内膜炎（PVIE）则更为罕见。慢性血液透析是发生感染性心内膜炎的一个危险因素。但该人群中复发性PVIE的情况尚无详尽描述。
病例摘要
一名32岁男性，患有终末期肾病，正在接受慢性血液透析，6个月前因未查明感染源而被诊断为PVIE，此次因复发性PVIE再次就诊，感染的是甲氧西林敏感菌，影像学检查发现新的肺脓毒性栓子和移植周围液体积聚，移植瓣膜被切除，后续培养结果为阴性。
讨论
通过该索引病例，我们描述了复发性孤立性PVIE的独特病理，并探讨了其诊断和管理方面的注意事项。
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