无乳链球菌感染性心内膜炎并急性肝衰竭1例

doi:10.3969/j.issn.1000-8535.2023.06.009

广州医药 ›› 2023, Vol. 54 ›› Issue (6): 52-55.DOI: 10.3969/j.issn.1000-8535.2023.06.009

无乳链球菌感染性心内膜炎并急性肝衰竭1例

赵金珍, 吕萍, 郑少忆

南方医科大学南方医院心血管外科（广州 510515）

收稿日期:2022-09-20 出版日期:2023-06-20 发布日期:2023-07-27
通讯作者: 郑少忆,E-mail：1052437402@qq.com

Streptococcus agalactiae infective endocarditis with acute liver failure

ZHAO Jinzhen, LV Ping, ZHENG Shaoyi

Department of Cardiovascular Surgery,Nanfang Hospital,Southern Medical University,Guangzhou 510515,China

Received:2022-09-20 Online:2023-06-20 Published:2023-07-27

摘要/Abstract

摘要： 目的探讨无乳链球菌感染性心内膜炎的临床特点和治疗效果。方法回顾性分析我院收治的1例无乳链球菌感染性心内膜炎合并急性肝衰竭患者的临床表现、诊疗经过及预后。结果经过积极抗感染、血浆置换和体外循环下赘生物清除、瓣膜置换手术治疗,术后继续予抗感染、抗凝等治疗,患者脏器功能恢复良好,取得了良好的治疗效果,并顺利出院。结论无乳链球菌感染性心内膜炎可引起急性心力衰竭、急性肝衰竭、急性肾衰竭等多脏器功能不全,合理把握手术时机和准确评估围术期风险有助于提高急危重症感染性心内膜炎患者的救治率。

关键词: 无乳链球菌, 感染性心内膜炎, 急性肝衰竭

Abstract: Objective To explore the clinical characteristics and treatment of infective endocarditis caused by Streptococcus agalactiae．Methods Clinical data and treatment details of a patient with Streptococcus agalactiae endocarditis and acute liver failure admitted to our hospital was analyzed retrospectively．Results After strict anti-biotic therapy and plasmapheresis,the patient received the vegetative removal and valve replacement and finally successfully recovered．Conclusions The diagnosis and treatment of this case suggests that Streptococcus agalactiae infective endocarditis can cause multiple organ dysfunction such as acute heart,liver and renal failure．Optimal timing of surgery and accurate benefits-risk assessment is helpful to improve the prognosis of patients with acute and severe infective endocarditis．

Key words: Streptococcus agalactiae, infective endocarditis, acute liver failure

赵金珍, 吕萍, 郑少忆. 无乳链球菌感染性心内膜炎并急性肝衰竭1例[J]. 广州医药, 2023, 54(6): 52-55.

ZHAO Jinzhen, LV Ping, ZHENG Shaoyi. Streptococcus agalactiae infective endocarditis with acute liver failure[J]. Guangzhou Medical Journal, 2023, 54(6): 52-55.

参考文献

[1] 刘鑫裴,苗齐.活动期感染性心内膜炎的外科治疗:进展与挑战[J].中国科学:生命科学,2021,51(8):970-978.
[2] REZAR R,LICHTENAUER M,HAAR M,et al.Infective endocarditis-A review of current therapy and future challenges[J].Hellenic J Cardiol,2021,62(3):190-200.
[3] NAKATANI S,OHARA T,ASHIHARA K,et al.JCS 2017 Guideline on Prevention and Treatment of Infective Endocarditis[J].Circ J,2019,83(8):1767-1809.
[4] CAHILL T J,BADDOUR L M,HABIB G,et al.Challenges in infective endocarditis[J].J Am Coll Cardiol,2017,69(3):325-344.
[5] GACA J G,SHENG S,DANESHMAND M A,et al.Outcomes for endocarditis surgery in North America:A simplified risk scoring system[J].J Thorac Cardiovasc Surg,2011,141(1):98-106.
[6] GATTI G,BENUSSI B,GRIPSHI F,et al.A risk factor analysis for in-hospital mortality after surgery for infective endocarditis and a proposal of a new predictive scoring system[J].Infection,2017,45(4):413-423.
[7] HE P C,WEI X B,LUO S N,et al.Risk prediction in infective endocarditis by modified MELD-XI score[J].Eur J Clin Microbiol Infect Dis,2018,37(7):1243-1250.
[8] GARCIA GRANJA P E,LOPEZ J,VILACOSTA I,et al.Prognostic impact of cardiac surgery in left-sided infective endocarditis according to risk profile[J].Heart,2021,107(24):1987-1994.
[9] DIAB M,SPONHOLZ C,von LOEFFELHOLZ C,et al.Impact of perioperative liver dysfunction on in-hospital mortality and long-term survival in infective endocarditis patients[J].Infection,2017,45(6):857-866.
[10] LIN P M F,CHOW S C Y,NG S W Y,et al.Acute liver failure with extreme hyperbilirubinemia secondary to endocarditis-related severe mitral and tricuspid regurgitation:a challenge and an opportunity for surgeons[J].J Thorac Dis,2018,10(2):1067-1071.
[11] HUGGINS J P,HOHMANN S,DAVID M Z.Candida infective endocarditis:A retrospective study of patient characteristics and risk factors for death in 703 United States cases,2015-2019[J].Open Forum Infect Dis,2021,8(2):ofaa628.
[12] WANG A,GACA J G,CHU V H.Management considerations in infective endocarditis:A review[J].JAMA,2018,320(1):72-83.
[13] 刘婧娴,陈星月,赵晶,等.非妊娠成人无乳链球菌感染临床特点及分子流行病学研究进展[J].检验医学,2022,37(8):793-797.
[14] ORAVEC T,ORAVEC S A,LEIGH J,et al.Streptococcus agalactiae infective endocarditis in Canada:a multicenter retrospective nested case control analysis[J].BMC Infect Dis,2022,22(1):18.
[15] SAMBOLA A,MIRO J M,TORNOS M P,et al.Streptococcus agalactiae infective endocarditis:analysis of 30 cases and review of the literature,1962-1998[J].Clin Infect Dis,2002,34(12):1576-1584.

无乳链球菌感染性心内膜炎并急性肝衰竭1例

Streptococcus agalactiae infective endocarditis with acute liver failure

PDF

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 2

编辑推荐

Metrics

本文评价

[1]	黄秋平, 吴静. 21例新生儿无乳链球菌败血症临床分析[J]. 广州医药, 2023, 54(5): 70-74.
[2]	张丽丽, 陈焰, 姚维敏, 郭健文. 恩替卡韦治疗e抗原阳性慢性乙型病毒性肝炎慢加急性肝衰竭的近期疗效与安全性研究[J]. 广州医药, 2019, 50(3): 102-104.