复发性假体大动脉膜阿斯伯吉勒斯内心炎 需要第四次重新根除手术
Krista Kaufmann1, Tess Calcagno1, Shinya Unai2
1Department of Internal Medicine, Cleveland Clinic, Cleveland, Ohio, USA.
JACC. Case reports
|March 13, 2026
概括
菌假内心炎是罕见的,难以诊断的. 先进的识别方法对于检测培养阴性病例中的真菌元素至关重要,这些病例具有门功能障碍和栓塞.
科学领域:
- 传染性疾病 传染性疾病
- 心脏病学 心脏病学
- 菌类学 菌类学是指菌类学.
背景情况:
- 真菌假内心炎 (FPVE) 是一种罕见但严重的疾病.
- 由于频繁的培养负结果和栓塞并发症,诊断具有挑战性.
- FPVE可能导致假体门功能障碍和显著的发病率.
研究的目的:
- 报告一种由神秘的阿斯伯吉卢斯物种引起的培养负FPVE病例.
- 突出诊断挑战和先进微生物技术的重要性.
- 强调在疑似FPVE的早期手术考虑的必要性.
主要方法:
- 一个58岁的男性患有假动脉功能障碍和栓塞事件的案例介绍.
- 诊断工作包括过食道心声学,血液培养,血清学测试和组织病理学.
- 用MALDI-TOF质谱法进行了物种鉴定.
主要成果:
- 这位患者出现了脏梗塞和假体门功能障碍.
- 心声图显示了一个不动的声密度,包围了门的升高梯度.
- 尽管消极的培养和膜凝血的初始治疗,患者经历了复发性栓塞. 组织病理学揭示了真菌元素,被确定为Aspergillus (Neosartorya) hiratsukae.
结论:
- 在这种情况下,传统的诊断方法是有限的.
- 先进的微生物识别,包括MALDI-TOF,对于诊断至关重要.
- 培养负的假功能障碍与栓塞,需要怀疑真菌内心炎,并立即进行手术评估.
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