Yoshimura T, Kitaura K, Sohma A, Satoh S, Wada Y, Oka T
Second Department of Surgery, Kyoto Prefectural University of Medicine, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1997 Jul;45(7):998-1002.
A case of successfully treated fungal tricuspid infective endocarditis with repeated pulmonary embolism is reported. A 60-year-old man had received along term intravenous hyperalimentation for the treatment of the complication after hepatopancreatoduodenectomy, associated with Candida sepsis. He was once discharged, successfully treated with antifungal agents. But he was readmitted to our hospital due to fever, cough and chest pain. Blood culture revealed Candida tropicalis. Pulmonary scintigraphy and angiography revealed multiple infarcts of the right lung, and echocardiography showed vegetation on the tricuspid valve. Because of exacerbation of shortness of breath, tricuspid valvuloplasty and thromboembolectomy in the pulmonary arteries was performed. Postoperative course was uneventful and he had a marked improvement of dyspnea after operation.
报告了一例成功治疗的真菌性三尖瓣感染性心内膜炎合并反复肺栓塞的病例。一名60岁男性因肝胰十二指肠切除术后并发症接受了长期静脉高营养治疗,并发念珠菌败血症。他曾出院,经抗真菌药物成功治疗。但他因发热、咳嗽和胸痛再次入院。血培养显示热带念珠菌。肺闪烁扫描和血管造影显示右肺多发梗死,超声心动图显示三尖瓣有赘生物。由于呼吸急促加重,进行了三尖瓣成形术和肺动脉血栓切除术。术后过程顺利,术后呼吸困难明显改善。