起搏器植入术后感染性心内膜炎1例  

One case of infective endocarditis after pacemaker implantation

作　　者：彭金华 颜友良[1] 郑丹[1] 杨靓淇 王贵明[1] 刘小军 王平 PENG Jin-hua;YAN You-liang;ZHENG Dan;YANG Jing-qi;WANG Gui-ming;LIU Xiao-jun;WANG Ping(Department of Cardiology,The Third Affiliated Hospital of Nanchang University,Nanchang,Jiangxi 330008)

机构地区：[1]南昌大学第三附属医院心内一科

出　　处：《赣南医学院学报》2019年第9期937-939,共3页JOURNAL OF GANNAN MEDICAL UNIVERSITY

摘　　要：起搏器电极导线植入心脏属于异物,但电极线上形成较大赘生物而产生感染性心内膜炎少见。本文报道1例因间断胸闷伴发热反复住院的心脏植入性电子装置感染性心内膜炎,明确诊断后予以万古霉素抗感染治疗后体温恢复正常,但考虑起搏器导线移除手术风险大,未行手术治疗。本病例的诊治提示我们心脏电子设备的植入亦是感染性心内膜炎的发病高危因素,如遇到既往行心脏电子装置植入术患者有反复高热,应复查血培养、心脏彩超及行核医学相关检查,考虑心脏植入性电子装置相关感染性心内膜炎可能。Pacemaker electrode wire implanted in the heart is a foreign body,however,large vegetations were formed on the electrode line and lead to infective endocarditis is rare.The article reporte a male patient with intermittent chest distress and fever for 1 years was hospitalized for recurrence of chest distress and fever 1 day,who had been misdiagnosed many times.After making a definitive diagnosis,vancomycin was given for anti-infection treatment and the body temperature returned to normal.But it was considered that pacemaker wire removal surgery was high risk and does not operative treatment.The case of diagnosis and treatment reminder of us,implantation of cardiac electronic devices was risk factors of infective endocarditis also.If the patients were with implantation of cardiac electronic devices and had fever,it is necessary to recheck blood culture,colour doppler echocardiography and Nuclear medicine related examination,considering infective endocarditis associated with implantable electronic devices in the heart possibility.

关 键 词：发热 心脏植入性电子装置 感染性心内膜炎 

分 类 号：R542.4[医药卫生—心血管疾病]