Ureche Corina, Moldovan Diana Lavinia, Vița Ionel, Guila Valeria, Nicola-Varo Teodora
Second Internal Medical Department, George Emil Palade University of Medicine, Pharmacy, Science and Technology, 540142 Târgu Mureș, Romania.
Clinical Emergency County Hospital, 540136 Târgu Mureș, Romania.
Reports (MDPI). 2025 Jul 31;8(3):127. doi: 10.3390/reports8030127.
Infective endocarditis (IE) is a serious condition with rising incidence, frequently caused by . However, cases involving rare congenital anomalies such as Gerbode's defect are uncommon. This report presents the first documented case of IE in a patient with a congenital Gerbode defect complicated by DRESS syndrome-a severe, drug-induced hypersensitivity reaction typically triggered by antibiotics like oxacillin. A 65-year-old woman developed infective endocarditis involving vegetations on the cardiac device lead, the tricuspid valve, and adjacent to a Gerbode defect. The diagnosis was confirmed by positive blood cultures and echocardiographic findings. She received treatment with oxacillin. Subsequently, she exhibited clinical features consistent with DRESS syndrome, including rash, eosinophilia, and multi-organ involvement. Rapid recognition and management, including corticosteroid therapy and antibiotic modification, led to clinical improvement. This case highlights the importance of vigilance for DRESS syndrome in prolonged antibiotic therapy for IE, especially in the context of rare congenital cardiac anomalies. In addition, guidelines are needed to optimize the diagnosis and treatment of this potentially lethal complication.
感染性心内膜炎(IE)是一种发病率不断上升的严重疾病,通常由……引起。然而,涉及如Gerbode缺损等罕见先天性异常的病例并不常见。本报告介绍了首例有文献记载的先天性Gerbode缺损患者并发药物性皮疹伴嗜酸性粒细胞增多和系统症状(DRESS)综合征的感染性心内膜炎病例,DRESS综合征是一种严重的药物性超敏反应,通常由苯唑西林等抗生素引发。一名65岁女性发生感染性心内膜炎,累及心脏装置导线、三尖瓣以及Gerbode缺损附近的赘生物。血培养阳性和超声心动图检查结果证实了诊断。她接受了苯唑西林治疗。随后,她出现了与DRESS综合征相符的临床特征,包括皮疹、嗜酸性粒细胞增多和多器官受累。迅速识别并进行包括皮质类固醇治疗和调整抗生素在内的处理,使病情得到临床改善。该病例凸显了在IE的长期抗生素治疗中,尤其是在罕见先天性心脏异常情况下,警惕DRESS综合征的重要性。此外,需要制定指南以优化这种潜在致命并发症的诊断和治疗。