PDF(Sci-hub)
Abstract：
BACKGROUND: Congenital heart defects predispose patients to a significantly increased risk of infective endocarditis (IE), and the incidence is even greater in the immunocompromised population. The involvement of multiple valves leads to a higher rate of complications and thus mortality. Moreover, biventricular IE is an uncommon condition with no specific guidelines for treatment.
METHODS: In this report, we discuss a case of an immunocompetent young male with a congenital perimembranous ventricular septal defect, complicated by multivalvular and right ventricular free wall vegetations. Biventricular involvement of IE along with septic embolization to both the pulmonary and systemic circulation resulted in challenges in the management of this patient.
CONCLUSIONS: The decision regarding timing and type (surgical vs. conservative) of treatment in such a complicated and aggressive IE case should be based on individual circumstances. However, the strategy of initial antibiotic therapy followed by surgical intervention can be a suitable option in such patients.
METHODS: In this report, we discuss a case of an immunocompetent young male with a congenital perimembranous ventricular septal defect, complicated by multivalvular and right ventricular free wall vegetations. Biventricular involvement of IE along with septic embolization to both the pulmonary and systemic circulation resulted in challenges in the management of this patient.
CONCLUSIONS: The decision regarding timing and type (surgical vs. conservative) of treatment in such a complicated and aggressive IE case should be based on individual circumstances. However, the strategy of initial antibiotic therapy followed by surgical intervention can be a suitable option in such patients.
摘要：
背景：先天性心脏缺陷使患者发生感染性心内膜炎（IE）的风险明显增加，在免疫受损人群中发病率更高。多个瓣膜的受累导致更高的并发症发生率和死亡率。此外，双心室IE是一种罕见的疾病，没有具体的治疗指南。
方法：在本报告中，我们讨论了一个有免疫能力的年轻男性先天性膜周部室间隔缺损的病例，并发多瓣膜和右心室游离壁植被。IE的双心室受累以及对肺循环和体循环的败血症栓塞导致该患者的管理面临挑战。
结论：关于时机和类型的决定(手术与保守）在这种复杂而积极的IE病例中，应根据个人情况进行治疗。然而,在此类患者中,初始抗生素治疗后手术干预的策略可能是一个合适的选择.
方法：在本报告中，我们讨论了一个有免疫能力的年轻男性先天性膜周部室间隔缺损的病例，并发多瓣膜和右心室游离壁植被。IE的双心室受累以及对肺循环和体循环的败血症栓塞导致该患者的管理面临挑战。
结论：关于时机和类型的决定(手术与保守）在这种复杂而积极的IE病例中，应根据个人情况进行治疗。然而,在此类患者中,初始抗生素治疗后手术干预的策略可能是一个合适的选择.
