在生物假体中心膜上培养确认的血清血内心炎在没有手术的情况下成功管理
Admire Hlupeni1, Adebisi Adejola2, Amirseena Tolebeyan2
1Internal Medicine Residency Department, St Luke's Hospital, Chesterfield, Missouri, USA; Faculty of Medicine, Midlands State University, Senga, Gweru, Zimbabwe.
JACC. Case reports
|October 3, 2025
概括
由Histoplasma capsulatum引起的假内心炎是罕见的. 使用抗原测试进行早期诊断和成功使用抗真菌药物进行非手术治疗是可能的.
科学领域:
- 传染性疾病 传染性疾病
- 菌类学 菌类学是指菌类学.
- 心脏病学 心脏病学
背景情况:
- 假内心炎 (PVE) 是心脏手术的一个严重并发症.
- 囊性血是一种很少涉及PVE的真菌,这给诊断带来了挑战.
研究的目的:
- 为了突出诊断和管理Histoplasma capsulatum假内心炎的复杂性.
- 强调非培养基诊断标记在早期检测中的实用性.
主要方法:
- 一个79岁的男性的病例报告,他有一个生物假体关,呈现PVE.
- 利用心声回声学,尿液质体抗原,血清β-D-葡萄糖和真菌血液培养物进行诊断.
- 用脂质体安波特 B 和 isavuconazole 进行管理.
主要成果:
- 这位患者表现出认知能力下降,全细胞减肥和高血症.
- 最初的血液培养是负的;然而,尿液抗原和β-D-葡萄糖是阳性的.
- 在长时间化后,真菌培养证实了Histoplasma capsulatum.
- 用抗真菌药物成功治疗导致没有手术的康复.
结论:
- 血清血内心炎需要在培养负的PVE中考虑,特别是在特有地区.
- 早期诊断可以通过抗原检测试验来促进.
- 伊萨夫可纳在伊特拉可纳适用时提供了替代治疗选择.
- 对于部分患者而言,非手术治疗是可行的.
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