猪红斑丹毒丝菌主动脉瓣心内膜炎一例报道及文献复习  

Aortic valve endocarditis caused by erysipelothrix rhusiopathiae:case report and literature review

作　　者：华平[1] 王萌[1] 刘家良[1] 江慧琦[1] 曾宽[1] 杨艳旗[1] 

机构地区：[1]中山大学孙逸仙纪念医院心胸外科,广州510120

出　　处：《中华临床医师杂志（电子版）》2013年第10期100-102,共3页Chinese Journal of Clinicians(Electronic Edition)

摘　　要：目的探讨猪红斑丹毒丝菌感染性心内膜炎的临床特点。方法对1例患有猪红斑丹毒丝菌致主动脉瓣心内膜炎的65岁男性患者的临床资料进行总结和分析并复习相关文献。结果患者因反复胸闷、心悸、气促2个月入院,术前血培养证实为猪红斑丹毒丝菌,超声心动图提示主动脉瓣脱垂、赘生物形成并重度关闭不全。考虑到患者心功能不全且赘生物较大,在应用青霉素抗感染24 h后,实施了急诊主动脉瓣置换+二尖瓣整形术。手术过程顺利,术后继续抗感染治疗4周后恢复良好,已痊愈出院。结论猪红斑丹毒丝菌是一种人兽共患病原体,与职业暴露有关,累及人的心脏瓣膜极为罕见,死亡率高。详细采集病史,早期诊断,早期治疗有助于改善预后。Objective To investigate the clinical features of infective endocarditis caused by Erysipelothrix rhusiopathiae.Methods The clinical data of a case of a 65-year-old male with infective aortic valve endocarditis caused by Erysipelothrix rhusiopathiae was summarized retrospectively and analyzed with a literature review.Results This patient was admitted with a chief complaint of chest tightness,palpitation and short breath for 2 months.Preoperative blood cultures were identified as Erysipelothrix rhusiopathiae and echocardiogram revealed aortic valve prolapse,severe aortic regurgitation with vegetation formation.Considering the patient＇s heart failure and large vegetation,we performed emergency aortic valve replacement and mitral valvuloplasty 24 hours after starting antibiotic therapy with Penicillin.The operation was successful.Antibiotic therapy continued for 4 weeks and the patient had a good postoperative recovery and was discharged.Conclusion Erysipelothrix rhusiopathiae can infect animals and humans,which is usually due to occupational exposure.Heart valves involvement in humans is extremely rare and has a high mortality.Detailed history,early diagnosis and early treatment can help to improve prognosis.

关 键 词：心内膜炎 丹毒丝菌属 心脏瓣膜 

分 类 号：R654.2[医药卫生—外科学]