Katayama Y, Yoshikai M, Minato N, Natsuaki M, Ito T
Department of Thoracic and Cardiovascular Surgery, Saga Medical School, Japan.
Kyobu Geka. 1996 Feb;49(2):143-5.
A 47-year-old woman was admitted to our hospital with high fever, exertional dyspnea and left flank pain. Echocardiography revealed vegetations attached to the aortic valve and moderate aortic regurgitation. Streptococcus anginosus was identified by blood culture examination. Abdominal CT scan showed a low density area in the spleen. The diagnosis of infective aortic valve endocarditis with splenic abscess was obtained. The splenectomy and the aortic valve replacement were performed simultaneously after the treatment with antibiotics. The postoperative clinical course was uneventful. In the case of infective endocarditis with splenic abscess, the splenectomy concomitant with valve surgery should be performed for removing all of the infected tissues.
一名47岁女性因高热、劳力性呼吸困难及左侧腰痛入院。超声心动图显示主动脉瓣有赘生物及中度主动脉瓣反流。血培养检查鉴定出咽峡炎链球菌。腹部CT扫描显示脾脏有低密度区。诊断为感染性主动脉瓣心内膜炎合并脾脓肿。在抗生素治疗后同时进行了脾切除术和主动脉瓣置换术。术后临床过程平稳。对于感染性心内膜炎合并脾脓肿的病例,应同时进行脾切除术和瓣膜手术以清除所有感染组织。