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经皮经静脉二尖瓣交界切开术后感染性二尖瓣心内膜炎1例

[A case of infective mitral endocarditis after percutaneous transvenous mitral commissurotomy].

作者信息

Inoue M, Sato S, Kato H, Sakagoshi N, Inoue T, Nagai I

机构信息

Department of Cardiovascular Surgery, Kinan General Hospital, Wakayama, Japan.

出版信息

Nihon Kyobu Geka Gakkai Zasshi. 1995 Apr;43(4):493-6.

PMID:7608599
Abstract

We encountered a case of infective mitral endocarditis (IE) due to Methicillin resistant staphylococcus aureus (MRSA) after percutaneous transvenous mitral commissurotomy (PTMC). A 65-year-old woman underwent PTMC for mitral stenosis. Two days later, she incurred a fever of more than 40 degrees C, and MRSA was detected in her blood culture. Inflammation and renal function deteriorated despite transvenous administration of antibiotics. Transesophageal echocardiogram revealed vegetation at the mitral valve. Mitral valve replacement was performed after diagnosis of IE, and MRSA was identified from the vegetation. The patient improved with the transvenous application of antibiotics including vancomycin hydrochloride. The blood culture became negative and inflammation was suppressed. In view of this case, we consider that IE is a possible complication following PTMC.

摘要

我们遇到了一例经皮经静脉二尖瓣交界切开术(PTMC)后因耐甲氧西林金黄色葡萄球菌(MRSA)引起的感染性二尖瓣心内膜炎(IE)病例。一名65岁女性因二尖瓣狭窄接受了PTMC。两天后,她出现体温超过40摄氏度的发热,血培养检测出MRSA。尽管经静脉给予抗生素,但炎症和肾功能仍恶化。经食管超声心动图显示二尖瓣有赘生物。诊断为IE后进行了二尖瓣置换术,从赘生物中鉴定出MRSA。患者通过经静脉应用包括盐酸万古霉素在内的抗生素后病情好转。血培养转为阴性,炎症得到抑制。鉴于此病例,我们认为IE是PTMC术后可能出现的并发症。

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