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NEJM：尺动脉真菌性动脉瘤-病例报道

2018-03-22 xing.T MedSci原创

尺动脉真菌性动脉瘤感染性心内膜炎
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该患者被诊断为亚急性细菌性心内膜炎，这可能与口腔卫生不良和最近的牙科手术有关。右壁CT血管造影显示尺动脉动脉瘤。

患者为一名27岁的男子，因左上腹疼痛和右手有搏动性疼痛病灶而到急诊就诊。患者报告一周来发热、食欲下降、盗汗和体重减轻12Kg。手掌上的疼痛性病变开始为局灶性红斑，但在2周内呈蓝色、突起、搏动。

体格检查体温为38.5°C，心前区3/6级舒张期杂音。实验室检查显示白细胞计数为18000mm3。腹部计算机断层扫描（CT）显示脾脏和左肾楔形梗死，超声心动图检查显示在二叶式主动脉瓣上存在赘生物，中度主动脉瓣关闭不全。两个从急诊获取的血液样本进行培养得到唾液链球菌是阳性，并且开始给予抗生素治疗。



该患者被诊断为亚急性细菌性心内膜炎，这可能与口腔卫生不良和最近的牙科手术有关。右壁CT血管造影显示尺动脉动脉瘤。

该患者接受主动脉瓣置换术，随后手术修复真菌性动脉瘤。其发热和盗汗症状在开始给予头孢曲松治疗开始后2天内消除。

原始出处：

Bashaar K. Alibrahim,et al. Ulnar-Artery Mycotic Aneurysm.N Engl J Med 2018. http://www.nejm.org/doi/full/10.1056/NEJMicm1603196

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    2018-08-31 ms5439512287675881

    #真菌性#

    0

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    2018-03-23 zhaojie88

    #真菌#

    0

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    2018-03-22 飛歌

    学习了很有用不错

    0

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    2018-03-22 明月清辉

    谢谢分享.学习了

    0

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    2018-03-22 1dd8c52fm63(暂无匿称)

    了解了解.学习学习

    0