孤立的肺瓣膜心内膜炎在一个未确诊的先天性心脏病的年轻人:一个罕见的临床实体

M. Njie, P. M. Mulendele, M. Selmaoui, M. Jiddou, A. Assklou, M. Haboub, A. Drighil, R. Habbal
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引用次数: 0

摘要

背景:孤立性肺瓣膜心内膜炎(PVE)是一种罕见的疾病,占所有报告的心内膜炎病例的1.5-2%。在此,我们描述一个罕见的病例孤立的肺动脉瓣心内膜炎与偶然发现的先天性心脏病在一个年轻的成人受试者。与其他右侧心内膜炎病例不同,我们对患者进行了药物和手术治疗。病例介绍:患者在血液培养后被诊断为孤立性肺动脉瓣心内膜炎,证实存在无营养缺陷,一种难以培养的细菌,同时超声心动图显示长8mm的植被团块,同时发现严重的肺动脉瓣狭窄和39mm宽的房间隔缺损(ASD)。脓毒性肺栓塞是本例患者的第一个临床表现。内科和外科治疗是基于双重抗生素,去除植被,瓣膜切开术和关闭ASD。 结论:先天性心脏病合并右侧心内膜炎患者应考虑内科治疗和早期手术治疗,以获得较好的临床效果。
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Isolated Pulmonary Valve Endocarditis on an Undiagnosed Congenital Heart Disease in a Young Adult: A Rare Clinical Entity
Background: Isolated pulmonary valve endocarditis (PVE) is a rare condition that accounts for 1.5–2% of all reported cases of endocarditis. Herein, we describe a rare case of isolated pulmonary valve endocarditis with a fortuitous discover of a congenital heart disease in a young adult subject. Unlike other cases of right sided endocarditis, we treated our patient both medically and surgically. Case Presentation: The patient was diagnosed with an isolated pulmonary valve endocarditis after blood cultures confirming the presence of Abiotrophia defectiva, a germ difficult to cultivate whilst the echocardiographic revealed a vegetation mass measuring 8mm long alongside with the discovery of a severe pulmonary valve stenosis and a large atrial septal defect (ASD) of 39mm wide. Septic pulmonary emboli were the first clinical manifestation in our patient. Both medical and surgical treatment was indicated based on dual antibiotics, removal of the vegetation, valvulotomy and closure of the ASD. Conclusion: Both medical and early surgery therapy should be considered in patient with right sided endocarditis associated with congenital heart disease for better clinical outcome.
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