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[非成瘾患者的念珠菌性心内膜炎:一种高死亡率的疾病。3例临床病理研究]

[Candida endocarditis in non-addict patients: a disease with high mortality. A clinico-pathological study of 3 cases].

作者信息

Pastor E, Renedo G, Fraile J, Gadea I, Fernández Guerrero M L

机构信息

División de Enfermedades Infecciosas (Departamento de Medicina), Fundación Jiménez Díaz, Universidad Autónoma de Madrid.

出版信息

Rev Clin Esp. 1994 Nov;194(11):978-81.

PMID:7846356
Abstract

Candida endocarditis is a rare infection which occurs under particular epidemiological circumstances, such a drug addiction, immunosuppression, prolonged intravenous therapy and valvular replacement surgery. Diagnosis requires a high suspicious index and is based on the demonstration of the organism in cardiac vegetations, peripheral embolisms or in positive blood-cultures; also when valvular insufficiency murmurs, embolic phenomena and echocardiogram-proved vegetations are present. In spite of antifungal therapy and valvular replacement, the mortality rate in Candida endocarditis is still higher than 80%. Three new cases of the entity are here reported stressing the diagnostic and therapeutical difficulties.

摘要

念珠菌性心内膜炎是一种罕见的感染,发生于特定的流行病学环境下,如药物成瘾、免疫抑制、长期静脉治疗及瓣膜置换手术等。诊断需要高度的怀疑指数,依据是在心脏赘生物、外周栓塞物中发现该病原体或血培养呈阳性;当出现瓣膜关闭不全杂音、栓塞现象及经超声心动图证实的赘生物时也可诊断。尽管进行了抗真菌治疗及瓣膜置换,念珠菌性心内膜炎的死亡率仍高于80%。本文报告了3例该疾病的新病例,强调了诊断和治疗上的困难。

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