感染性内心炎导致系统性红斑狼患者急性大动脉封闭:一个罕见的病例报告
James Dodd1, Amirul Hakim Ahmad Bazlee1, Thomas Begg1
1Department of Vascular Surgery, Royal Perth Hospital, Perth 6000, Australia.
International journal of surgery case reports
|January 28, 2025
概括
传染性内心炎 (IE) 可能导致罕见但严重的并发症,如急性大动脉封闭,导致肢体缺血. 这一案例凸显了在具有复杂症状的免疫抑制患者中考虑IE的重要性.
科学领域:
- 心脏病学 心脏病学
- 传染性疾病 传染性疾病
- 血管外科 血管外科
背景情况:
- 传染性内心炎 (IE) 是一种严重的感染,具有显著的发病率和死亡率.
- 血栓事件在IE中很常见,发生在高达80%的患者中.
- 对IE次要的急性大动脉闭塞是一种罕见但毁灭性的并发症.
研究的目的:
- 报告一种独特的,由感染性内心炎引起的双边下肢急性大动脉封闭病例.
- 强调在急性四肢缺血的差异诊断中考虑IE的重要性,特别是在免疫功能低下的患者中.
主要方法:
- 一个澳大利亚土著妇女的案例研究,患有全身性红斑狼,呈现急性四肢缺血症状.
- 诊断工作包括计算机断层扫描血管学,心声学和磁共振成像.
- 治疗涉及广泛的抗生素,肝素输液,血栓切除术和带切除术.
主要成果:
- 确定了远端主动脉和下肢血管的多焦点闭塞.
- 感染性内心炎是由甲基西林敏感黄金葡萄球菌引起的证实.
- 患者经历了脊髓梗塞,但在长时间住院后最终恢复了行走能力.
结论:
- 这是第一个报告的IE继发的急性大动脉封闭病例,影响双边下肢.
- 来自IE的败血栓可以堵塞主要动脉,导致急性四肢缺血症.
- 对于精确的诊断和管理来说,对复杂的并发症中血栓的全面了解至关重要.
相关概念视频
Aortic Regurgitation I: Introduction
IntroductionAortic regurgitation is characterized by the backward flow of blood from the aorta into the left ventricle during diastole and arises from the improper closure of the aortic valve. This condition results in left ventricular volume overload and can stem from both acute and chronic etiologies, each contributing uniquely to the disease's progression and symptomatology.Acute and Chronic CausesAcute aortic regurgitation often results from events that suddenly impair the integrity of the...
Endocarditis I: Introduction
Introduction:Endocarditis is the infection of the endocardium, the inner lining of the heart and its valves. When the heart muscle is involved, the condition is termed myocarditis, while an infection of the outer lining is called pericarditis. Infective endocarditis (IE) primarily affects the endocardium, where pathogens adhere to the valves or lining, forming vegetation that can lead to severe complications. Infective endocarditis occurs when microorganisms, usually bacteria from other body...
Endocarditis II: Clinical Features of Infective Endocarditis
Endocarditis can present various clinical features depending on the causative organism and the patient's underlying health conditions. Initially, the clinical features of infective endocarditis develop gradually, presenting with nonspecific symptoms that can be easily mistaken for other illnesses.General SymptomsEarly symptoms of infective endocarditis are fever, chills, weakness, malaise, fatigue, and weight loss. These symptoms reflect the systemic nature of the infection and the body's...
Endocarditis III: Medical Management
Infective endocarditis management involves a multifaceted approach encompassing infection prevention, lifestyle modifications, pharmacological therapy, and surgical management.Infection Prevention:Hand Hygiene: Thorough handwashing is crucial to prevent the spread of infection. Hand hygiene should be performed regularly, especially before and after using the restroom.Oral Hygiene: Good oral hygiene is essential. It includes brushing teeth immediately after waking up and before bed, flossing...
Endocarditis IV: Nursing Management
Infective endocarditis (IE) is a chronic infection of the heart's endocardium, primarily affecting the heart valves. A detailed nursing assessment for a patient with IE involves collecting subjective and objective data to ensure an accurate diagnosis and timely intervention.Subjective DataThe nurse gathers information about the patient's symptoms and complaints during the subjective assessment. Patients with infective endocarditis often report non-specific symptoms that can mimic other...
Rheumatic Heart Disease I: Introduction
Rheumatic heart disease or RHD is a chronic condition that results from rheumatic fever, causing permanent damage to the heart valves.Etiology and Risk FactorsIt primarily arises from rheumatic fever, an inflammatory disease that can develop after untreated or inadequately treated group A streptococcal (GAS) pharyngitis. Streptococcus spreads through direct contact with oral or respiratory secretions. While the bacteria are the causative agents, factors like malnutrition, overcrowding, poor...


