PDF(Pubmed)
Abstract：
The perivalvular cardiac abscess is a severe condition associated with infective endocarditis, leading to significant morbidity and mortality if not diagnosed and managed promptly. Neurological complications, particularly stroke, can occur due to embolic events resulting from cardiac abscesses. A 63-year-old female with end-stage renal disease and multiple comorbidities presented with altered mental status. Imaging revealed acute ischemic infarcts in the frontotemporal lobes, suggesting the embolic phenomenon. Blood cultures grew Enterococcus faecalis, and an echocardiogram showed severe aortic valve destruction with perivalvular abscess. Cardiac abscesses can cause severe complications, including tissue destruction, valve damage, and embolic events. Echocardiography is crucial for diagnosis, detecting vegetation, and assessing associated complications. Transthoracic echocardiography is reliable but has limitations, whereas transesophageal echocardiography is highly sensitive. Prompt antibiotic therapy and surgical intervention are crucial for treatment. Early initiation of appropriate antibiotic therapy and surgical intervention is crucial for positive outcomes. The choice of treatment should be individualized based on the patient\'s specific condition and the medical team\'s expertise.
摘要：
心脏瓣膜周围脓肿是一种与感染性心内膜炎相关的严重疾病，导致显著的发病率和死亡率，如果不及时诊断和管理。神经系统并发症,尤其是中风，可能是由于心脏脓肿引起的栓塞事件而发生的。一名63岁女性，患有终末期肾病和多种合并症，精神状态改变。影像学显示额颞叶急性缺血性梗塞，提示了栓塞现象.血培养物生长粪肠球菌,超声心动图显示主动脉瓣严重破坏伴瓣膜周围脓肿。心脏脓肿会引起严重的并发症,包括组织破坏,阀门损坏,和栓塞事件。超声心动图对诊断至关重要，探测植被，并评估相关并发症。经胸超声心动图是可靠的，但有局限性，而经食管超声心动图高度敏感。及时的抗生素治疗和手术干预对治疗至关重要。早期开始适当的抗生素治疗和手术干预对于积极的结果至关重要。应根据患者的具体情况和医疗团队的专业知识，个性化选择治疗方法。
