感染性内心炎是由前身健康的男性中Streptococcus viridans引起的:一个病例报告
Sara Fontaínhas1, Bárbara Baptista1, Maria I Bertão1
1Internal Medicine, Hospital Distrital da Figueira da Foz, Figueira da Foz, PRT.
Cureus
|February 4, 2025
概括
本案例研究详细介绍了36岁的健康男性感染性内心炎 (IE),由Streptococcus viridans引起. 它强调了诊断方面的挑战,以及对这种严重的心脏膜感染及时诊断的重要性.
科学领域:
- 传染性疾病 传染性疾病
- 心脏病学 心脏病学
- 内部医学 内部医学
背景情况:
- 传染性内心炎 (IE) 是一种严重的心脏膜感染,通常是由链球菌,葡萄球菌和肠球菌等细菌引起的.
- 脑膜炎可能表现出非特异性症状,导致诊断延迟,特别是在没有典型危险因素的患者中.
研究的目的:
- 在以前健康的年轻成年人中报告由Streptococcus viridans引起的感染性内心炎 (IE) 病例.
- 强调在非典型病例中IE的诊断挑战和惰表现.
- 要强调考虑长期发烧和阳性血液培养的患者的IE的重要性.
主要方法:
- 一个36岁的男性病例报告,有3周的发烧,夜间出汗和疲劳史.
- 假定非典型感染的初始经验性用多西环林治疗.
- 诊断工作包括血培养,胸前心声扫描 (TTE) 和食道间心声扫描 (TEE).
主要成果:
- 血液培养证实了Streptococcus viridans是病原体.
- 心声检查显示先天性大动脉膜病变 (双大动脉) 与中度反.
- 经食道心声学 (TEE) 确定了植被,证实了传染性内心炎 (IE).
- 用塞夫特里亚克松和 gentamicin 治疗导致一个有利的临床反应在四周后.
结论:
- 传染性内心炎 (IE) 可以潜伏地出现,即使在没有先前心脏病的年轻健康个体中也是如此.
- 及时诊断和适当的抗生素治疗对于预防IE严重并发症至关重要.
- 这一案例强调了在患有无法解释的发烧和阳性血培养的患者中对IE的高怀疑指数的需要.
相关概念视频
01:26Healthcare Associated Infections I: Iatrogenic, Exogenic and Endogenic
5.7K
Healthcare-associated infections (HAIs) occur in a healthcare facility while a person receives care for another ailment. This category also includes work-related infections among healthcare staff.
HAIs significantly increase the cost of health care. Extended stays in healthcare institutions, increased disability, increased costs of medications, including specialized antibiotics, and prolonged recovery times add to the patient's expenses and the healthcare institution and funding bodies.
HAIs significantly increase the cost of health care. Extended stays in healthcare institutions, increased disability, increased costs of medications, including specialized antibiotics, and prolonged recovery times add to the patient's expenses and the healthcare institution and funding bodies.
5.7K
01:25Endocarditis I: Introduction
873
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...
873
01:25Endocarditis II: Clinical Features of Infective Endocarditis
929
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...
929
01:18Endocarditis III: Medical Management
360
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...
360
01:29Endocarditis IV: Nursing Management
630
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...
630
01:23Rheumatic Heart Disease I: Introduction
1.0K
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...
1.0K