PDF(Pubmed)
Abstract：
Right-sided infective endocarditis is less common than left-sided endocarditis and can be a difficult clinical diagnosis. The presence of intracardiac devices is a major risk factor. The presentation is less clear than left-sided forms because of the presence of respiratory symptoms and the absence of systemic embolization. Pylephlebitis, or septic thrombosis of the portal vein, is a serious infectious condition that often delays diagnosis. It is a complication of intraabdominal or pelvic infections. Streptococcus gallolyticus (S. gallolyticus) can cause infective endocarditis and is associated with colon neoplasia and hepatobiliary disease. In this case report, we describe the case of a 76-year-old male with a history of rectal adenocarcinoma who presented with different episodes of fever of unknown origin (FUO), one of which occurred after pacemaker implantation. Ultimately, he was diagnosed with S. gallolyticus-mediated tricuspid valve endocarditis with underlying pylephlebitis. Investigations did not show evidence of pacemaker lead endocarditis.
摘要：
右侧感染性心内膜炎不如左侧心内膜炎常见，临床诊断困难。心内装置的存在是主要的危险因素。由于存在呼吸道症状和没有全身性栓塞，因此其表现不如左侧形式清晰。静脉炎,或门静脉的感染性血栓形成，是一种严重的传染病，通常会延误诊断。它是腹腔或盆腔感染的并发症。溶胆链球菌（S.胆溶病）可引起感染性心内膜炎，并与结肠瘤形成和肝胆疾病有关。在这个案例报告中,我们描述了一名76岁男性，有直肠腺癌病史，表现为不明原因发热（FUO）的不同发作，其中之一发生在起搏器植入后。最终,他被诊断为胆囊溶血性链球菌介导的三尖瓣心内膜炎伴基础性静脉炎.调查未显示起搏器导线心内膜炎的证据。
