由于Coxsackie B病毒引起的急性发烧性心肌炎
Suhas R Seshadri1, Edward Salem1, Andrew Carlson1
1Internal Medicine, University of Illinois at Chicago, Chicago, USA.
Cureus
|March 28, 2025
概括
爆发性心肌炎是一种严重的心脏病,可由Coxsackie B病毒引起. 这个案例突出了这种严重疾病的诊断和管理策略.
科学领域:
- 心脏病学 心脏病学
- 传染性疾病 传染性疾病
- 免疫学 免疫学 免疫学
背景情况:
- 发性心肌炎是一种危及生命的急性心肌炎形式.
- 它呈现出严重的血液动力学妥协,往往需要机械循环支持.
- 病因包括感染,毒素和自身免疫性疾病.
研究的目的:
- 在以前健康的53岁男性中呈现 fulminant 心肌炎病例.
- 详细说明诊断过程,包括血清学测试和心脏核磁共振.
- 讨论这个关键条件的多方面的管理方法.
主要方法:
- 临床表现审查:发烧,呼吸困难和上呼吸道症状.
- 诊断工作:病毒病因的血清学测试,心脏MRI与晚期加多增强 (LGE).
- 治疗干预措施:指南导向医学疗法 (GDMT),高剂量类固醇,静脉注射免疫球蛋白和机械循环支持.
主要成果:
- 患者出现了严重的左心室功能障碍和心脏性休克.
- 最初的病毒血清学是负的;重复测试证实了Coxsackie B病毒感染.
- 心脏MRI显示了与心肌炎一致的特征性LGE模式.
结论:
- 考克萨基B病毒甚至在没有先前病史的人身上也会引起发性心肌炎.
- 综合诊断方法,包括先进的成像,对于及时诊断至关重要.
- 涉及GDMT,免疫疗法和机械支持的综合管理对于患者的生存至关重要.
更多相关视频
06:49Quantitative Visualization of Leukocyte Infiltrate in a Murine Model of Fulminant Myocarditis by Light Sheet Microscopy
Published on: May 31, 2017
06:03Use of Viral Entry Assays and Molecular Docking Analysis for the Identification of Antiviral Candidates against Coxsackievirus A16
Published on: July 15, 2019
相关概念视频
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...
Myocarditis I: Introduction
Myocarditis is inflammation of the myocardium, which is the muscular layer of the heart.EtiologyMyocarditis has a diverse etiology, including a wide range of infectious and non-infectious causes:Infectious CausesViral: Common viruses include Coxsackie A and B, adenovirus, parvovirus B19, enteroviruses, and influenza A.Bacterial: Examples include infections caused by Streptococcus, Staphylococcus, and Mycoplasma species.Rickettsial: Infections like Rocky Mountain spotted fever can result in...
Myocarditis II: Clinical Features and Diagnostic Tests
Myocarditis is an inflammation of the heart muscle. The symptoms vary widely, encompassing asymptomatic presentations to severe, acute manifestations.Clinical PresentationAsymptomatic cases: In some instances, myocarditis may be asymptomatic, with the infection resolving without intervention. These cases often go undetected unless discovered incidentally through diagnostic imaging or tests conducted for other reasons.General Early Symptoms: Early symptoms of myocarditis are non-specific and can...
Myocarditis III: Medical Management
Myocarditis: Comprehensive Medical ManagementMyocarditis, the heart muscle inflammation, requires a comprehensive medical management strategy that addresses the underlying cause, provides supportive care, manages symptoms, and reduces cardiac workload.Infections and Autoimmune CausesAdminister appropriate antimicrobial therapy when an infectious agent causes myocarditis. For instance, penicillin treats infections caused by Group A Streptococcus. In cases where autoimmune processes are...
Myocarditis IV: Nursing Management
Myocarditis is an inflammatory condition of the myocardium requiring meticulous nursing management for optimal patient outcomes. Effective management begins with a thorough assessment of the patient's medical history, paying close attention to past infections, autoimmune disorders, travel history, and exposure to toxins or drugs. Recent viral infections and systemic diseases are particularly relevant due to their potential role in triggering myocarditis.Physical Examination and MonitoringThe...
