一种典型的非典型疾病病例:"三个不"感染性内心炎
Masashi Yokose1, Takanobu Hirosawa1, Keita Tsunashima2
1Department of Diagnostic and Generalist Medicine, Dokkyo Medical University, Mibu, JPN.
Cureus
|August 26, 2024
概括
非典型的传染性内心炎,定义为"三个noes",可以微妙地呈现. 这一案例突出了青少年患有亚托皮性皮肤炎的甲素敏感黄金菌内心炎.
科学领域:
- 传染性疾病 传染性疾病
- 心脏病学 心脏病学
- 皮肤病学 皮肤病学
背景情况:
- 识别感染性内心炎 (IE) 的非典型表现对于准确诊断和改善患者的治疗结果至关重要.
- "三个不"的IE分类 (没有左侧IE,没有静脉药物使用,没有心脏器械) 描述了一组具有独特挑战的病例.
- 亚托邦性皮肤炎曾经与传染性皮肤炎有关,这表明与传染过程的潜在关联.
研究的目的:
- 报告一种具有非典型特征的"三不"感染性内心炎病例.
- 探索亚托皮性皮肤炎和IE之间的潜在关联.
- 强调考虑IE在患有发烧和不显著的初始检查的患者,特别是患有亚托皮炎的患者中的重要性.
主要方法:
- 一个16岁的男性患有亚托皮性皮炎,呈现出长期间歇性发烧的病例报告.
- 最初的评估包括体检,血液检查和对口服抗生素的反应.
- 在症状复发时重复诊断工作,导致心声回声和血液培养.
主要成果:
- 患者出现了一个月的发烧和发寒史,最初对抗生素有反应.
- 初步调查显示,没有心脏声或外围栓塞迹象.
- 重复出现的症状导致诊断为三膜感染性内心炎,由甲基西林敏感的金黄色葡萄球菌引起.
结论:
- 这一案例说明了在患有亚托皮性皮肤炎的患者身上"三不"感染性内心炎的呈现.
- 临床医生应在患有无形性皮肤炎的患者中保持对IE的高度怀疑指数,即使缺乏典型的IE污名,也会出现无法解释的发烧.
- 早期和彻底的调查对于诊断非典型IE病例至关重要,以防止诊断延迟和改善患者的预后.
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