Robles P, García-Gallego F, de Alba J, García J, Domínguez F J, Oliver J M
Servicio de Cardiología, Hospital la Paz, Madrid.
Rev Esp Cardiol. 1997 May;50(5):360-2. doi: 10.1016/s0300-8932(97)73235-4.
We report the first case of Clostridium clostridiformis endocarditis in a 71 year old man with an aortic prosthetic valve. He was febrile with left upper quadrant pain and left lower lobe infiltrate in chest X ray. The diagnosis was made by gram-positive bacilli grown from three blood cultures. Transthoracic and transesophageal echocardiogram showed a paraaortic abscess. A computed tomographic scan of the abdomen revealed a large splenic abscess. He received penicillin G 4 million units every 4 hours intravenously. A successful percutaneous drainage guided computed tomographic scan was performed. The patient remained febrile and a new computed tomographic scan of the abdomen revealed residual splenic abscess. A splenectomy was performed. The patient defervesced on the second day of surgery and remained afebrile during the remainder of his hospitalization. He has returned for medical follow-up and two years later the patient is asymptomatic.
我们报告了首例患有主动脉人工瓣膜的71岁男性患梭状芽孢杆菌心内膜炎的病例。他发热，伴有左上腹疼痛，胸部X光显示左下叶有浸润影。诊断依据是从三次血培养中培养出革兰氏阳性杆菌。经胸和经食管超声心动图显示主动脉旁脓肿。腹部计算机断层扫描显示一个大的脾脓肿。他接受静脉注射每4小时400万单位青霉素G。在计算机断层扫描引导下成功进行了经皮引流。患者仍发热，腹部新的计算机断层扫描显示脾脓肿残留。于是进行了脾切除术。患者在手术第二天退热，住院期间其余时间未再发热。他已回来接受医学随访，两年后患者无症状。
