PDF(Pubmed)
Abstract：
Infective endocarditis is a rare but life-threatening condition, occasionally linked to diverse immunologic manifestations, including mixed cryoglobulinemia. This can lead to cryoglobulinemic vasculitis, which has the potential for widespread organ damage. Although some cases have highlighted the relationship between infective endocarditis and cryoglobulinemic vasculitis, no comprehensive epidemiological evaluation or optimal treatment strategies have been advanced for such a combination. We present a case of methicillin-sensitive Staphylococcus aureus infective endocarditis associated with cryoglobulinemic vasculitis and conduct a literature review to compare management and outcomes in similar cases. Our patient presented with classical Meltzer\'s triad and mild renal involvement. Cryoimmunofixation confirmed type III cryoglobulinemia, and serum cytokines showed elevated IL-6 levels. The differential diagnosis included infective endocarditis and chronic active hepatitis C virus infection. Rapid symptom resolution after antibiotic treatment identified infective endocarditis as the likely cause of cryoglobulinemic vasculitis. Our case and review of the literature highlight that early identification of the cause of cryoglobulinemic vasculitis is crucial for selecting appropriate treatment and preventing recurrence or morbidity.
摘要：
感染性心内膜炎是一种罕见但危及生命的疾病,偶尔与不同的免疫学表现有关，包括混合型冷球蛋白血症.这可能导致冷球蛋白血症性血管炎，有可能导致广泛的器官损伤。尽管有些病例强调了感染性心内膜炎和冷球蛋白性血管炎之间的关系，没有针对这种组合进行全面的流行病学评估或最佳治疗策略.我们介绍了一例甲氧西林敏感的金黄色葡萄球菌感染性心内膜炎与冷球蛋白性血管炎相关的病例，并进行了文献综述，以比较类似病例的治疗和结局。我们的患者表现为经典的Meltzer三联征和轻度肾脏受累。冷冻免疫固定证实III型冷球蛋白血症，血清细胞因子显示IL-6水平升高。鉴别诊断包括感染性心内膜炎和慢性活动性丙型肝炎病毒感染。抗生素治疗后症状迅速缓解，确定感染性心内膜炎是冷球蛋白性血管炎的可能原因。我们的案例和文献综述强调，早期识别冷球蛋白性血管炎的病因对于选择适当的治疗方法和预防复发或发病率至关重要。
