PDF(Pubmed)
Abstract：
Infective endocarditis (IE) is a rare but serious infection of the cardiac endothelium. This case report presents a rare instance of left-sided Pseudomonas aeruginosa endocarditis in an immunocompetent patient without traditional risk factors for IE. Pseudomonas endocarditis is uncommon and usually associated with specific factors. The patient in this case was a 30-year-old male with end-stage renal disease, receiving hemodialysis through a tunneled dialysis catheter, who developed a fever. Blood cultures confirmed P. aeruginosa as the causative agent, which prompted the administration of appropriate antibiotics and the removal of the catheter. However, subsequent imaging revealed significant damage to the mitral valve. Despite timely mitral valve replacement and aggressive medical treatment, the patient\'s condition worsened, and he ultimately succumbed to the infection. This case also emphasizes the necessity of timely diagnosis and intervention. In this patient, by the time it was diagnosed and managed, significant mitral valve damage had already occurred. Therefore, it should be considered a differential diagnosis even in patients with no risk factors and should be managed vigorously. Pseudomonas endocarditis is associated with high mortality, and successful treatment often requires a combination of antipseudomonal antibiotics due to the organism\'s ability to develop resistance. Surgical intervention, such as valve replacement, is frequently necessary. This case underscores the importance of considering P. aeruginosa infection, even in patients without traditional risk factors for IE. Early diagnosis, appropriate antibiotic therapy, and timely surgical intervention are critical for improving outcomes in Pseudomonas endocarditis cases.
摘要：
感染性心内膜炎（IE）是一种罕见但严重的心脏内皮感染。该病例报告介绍了在没有传统IE危险因素的免疫功能正常的患者中罕见的左侧铜绿假单胞菌心内膜炎。假单胞菌心内膜炎并不常见，通常与特定因素有关。这个病例的病人是一名30岁的男性，患有终末期肾病，通过隧道透析导管接受血液透析，发烧的人。血培养证实铜绿假单胞菌是病原体，这促使给予适当的抗生素和拔除导管。然而,随后的成像显示二尖瓣明显受损.尽管及时进行二尖瓣置换术和积极的治疗，病人的病情恶化了，他最终死于感染。这一案例也强调了及时诊断和干预的必要性。在这个病人身上,当它被诊断和管理时，显著的二尖瓣损伤已经发生。因此,即使在没有危险因素的患者中，也应将其视为鉴别诊断，并应大力管理。假单胞菌心内膜炎与高死亡率相关，而成功的治疗往往需要联合使用抗假单胞菌抗生素，因为这种生物体具有产生耐药性的能力。手术干预,如瓣膜置换，往往是必要的。这个案例强调了考虑铜绿假单胞菌感染的重要性，即使是没有传统IE危险因素的患者。早期诊断,适当的抗生素治疗，及时的手术干预对于改善假单胞菌心内膜炎病例的预后至关重要.
