Anderson Lindsay, Nguyen Lisa
Division of General Internal Medicine, Department of Medicine, Queen's University, Kingston, ON, Canada.
Obstet Med. 2025 Apr 24:1753495X251335360. doi: 10.1177/1753495X251335360.
We report the case of a 21-year-old woman at 29 weeks and four days of gestation who presented with one-week history of severe epigastric pain, pleuritic chest pain, dyspnoea, and chills. A peripherally inserted central catheter line had been placed at 14 weeks of gestation for outpatient management of hyperemesis gravidarum. Initial investigations included a transthoracic echocardiogram which revealed a large tricuspid valve vegetation with mild tricuspid regurgitation and CT pulmonary angiogram which identified multiple septic pulmonary emboli. Blood cultures grew methicillin-susceptible . Despite appropriate antimicrobial therapy, they remained bacteraemic and underwent percutaneous mechanical debulking of tricuspid valve infective endocarditis using an AngioVac aspiration thrombectomy device. Their clinical course post-AngioVac was complicated by the development of multiple pulmonary emboli and suspected left-sided empyema. They delivered by caesarean section at 32 weeks and one day of gestation due to maternal health reasons.
我们报告了一例21岁女性患者，妊娠29周零4天，有一周的严重上腹部疼痛、胸膜炎性胸痛、呼吸困难和寒战病史。患者在妊娠14周时放置了一根经外周静脉穿刺中心静脉导管，用于门诊治疗妊娠剧吐。初步检查包括经胸超声心动图，显示三尖瓣有一个大的赘生物，伴有轻度三尖瓣反流，以及CT肺动脉造影，发现多个脓毒性肺栓塞。血培养结果显示对甲氧西林敏感。尽管进行了适当的抗菌治疗，患者仍持续菌血症，并使用AngioVac抽吸血栓清除装置对三尖瓣感染性心内膜炎进行了经皮机械减容治疗。患者在接受AngioVac治疗后的临床过程因多发性肺栓塞和疑似左侧脓胸的发生而复杂化。由于母体健康原因，患者在妊娠32周零1天时行剖宫产分娩。
