中枢神经系统损害为首发的感染性心内膜炎病例报道1例-现代医学

中枢神经系统损害为首发的感染性心内膜炎病例报道1例

单位：1. 广东医科大学第一临床医学院, 广东惠州 516000;
2. 广东省惠州市第一人民医院神经内科, 广东惠州 516000

分类号：R542.4

出版年·卷·期（页码）：2020·39·第八期（1057-1060）

摘要：

目的：探讨感染性心内膜炎引起中枢神经系统损害的原因、诊疗及预后，以提高临床医师对本病临床特征的认识，减少临床误诊，改善预后。方法：报道1例我院以中枢神经系统损害为首发症状的感染性心内膜炎患者的临床资料并进行了相关文献复习。结果：对于感染性心内膜患者早期予抗生素及手术治疗可以减少栓塞并发症的发生。结论：对于明确为感染性心内膜炎的患者因尽早给予抗生素及手术治疗以减少中枢神经系统损害事件的发生，改善患者的预后。

Objective: To investigate the causes, diagnosis, treatment and prognosis of central nervous system damage caused by infective endocarditis, in order to improveclinicians' understanding of the clinical features of the disease, reduce clinical misdiagnosis and improve prognosis. Methods: A case of infective endocarditis with central nervous system injury as the first symptom in our hospital was reported.Results: For patients with infective endocarditis, early antibiotics and surgical treatment can reduce the incidence of embolism complications. Conclusion: For patients with infective endocarditis, antibiotics and surgical treatment should be given as early as possible to reduce the incidence of central nervous system damage and improve the prognosis.

参考文献：

[1] CONE L A,HIRSCHBERG J,LOPEZ C,et al.Infective endocarditis associated with spondylodiscitis and frequent secondary epidural abscess[J].Surgical Neurology,2008,69(2):121-125.
[2] FRANZ M,BAHRMANN P,BEMDT A,et al.Surgical therapy of infective endocarditis.General aspects and case report[J].Medizinische Klinik,2008,103(5):349-355.
[3] SILVER B,BEHROUZ R,SILLIMAN S.Bacterial endocarditis and cerebrovascular disease[J].Current Neurology & Neuroscience Reports,2016,16(12):104.
[4] GRECU N,TIU C,TERECOASA E,et al.Endocarditis and stroke[J].Maedica,2014,9(4):375-381.
[5] HUI F K,BAIN M,OBUCHOWSKI N A,et al.Mycotic aneurysm detection rates with cerebral angiography in patients with infective endocarditis[J].Journal of Neurointerventional Surgery,2015,7(6):449-452.
[6] PETERS P J,HARRISON T,LENNOX J L.A dangerous dilemma:management of infectious intracranial aneurysms complicating endocarditis[J].Lancet Infectious Diseases,2006,6(11):742-748.
[7] DICKERMAN S A,ABRUTYN E,BARSIC B,et al.The relationship between the initiation of antimicrobial therapy and the incidence of stroke in infective endocarditis:an analysis from the ICE prospective cohort study(ICE-PCS)[J].American Heart Journal,2007,154(6):1086-1094.
[8] SLIVER B,BEHROUZ R,SILLIMAN S.Bacterial endocarditis and cerebrovascular disease[J].Current Neurology & Neuroscience Reports,2016,16(12):104.
[9] 李进伟,田力,薛维爽,等.感染性心内膜炎合并卒中3例及文献复习[J].中风与神经疾病杂志,2018,35(1):22-25.
[10] GARCIACABRERA E,FEMNANDEZHIDALGO N,ALMIRANTE B,et al.Neurologic complications of infective endocarditis:risk factors,outcome,and impact of cardiac surgery:a multicenter observational study[J].Prenatal Diagnosis,2013,15(5):455-465.
[11] 席文娜,龚文兰,严敬,等.162例感染性心内膜炎临床特征分析[J].新发传染病电子杂志,2017,2(1):40-42.
[12] ROSSI M,GALLO A,SILVA R J D,et al.What is the optimal timing for surgery in infective endocarditis with cerebrovascular complications?[J].Interactive Cardiovascular & Thoracic Surgery,2012,14(1):72-80.
[13] 中华医学会心血管病学分会.成人感染性心内膜炎预防、诊断和治疗专家共识[J].中华心血管病杂志,2014,42(10):806-816.

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