感染性心内膜炎合并脑出血临床特点分析

Analysis of Clinical Features of Infective Endocarditis Complicated with Cerebral Hemorrhage

目的探讨感染性心内膜炎合并脑出血的临床表现、影像学特点以及细菌学特点。方法收集3例感染性心内膜炎合并脑出血病人的临床资料,结合国内外文献报道的18例病例资料,对病人的临床表现、影像学特点、细菌学特点等进行复习、讨论。结果 21例感染性心内膜炎合并脑出血病人临床表现以头痛、偏瘫及意识障碍为多见,多数为单发或多发实质出血,出血部位多见于脑叶,金黄色葡萄球菌和草绿色链球菌为最常见致病菌,二尖瓣受累最常见。结论感染性心内膜炎合并脑出血较为少见,当感染性心内膜炎病人出现神经系统症状时临床医生应给予足够重视。

Objective To investigate the clinical manifestations,imaging features and bacteriological features of infective endocarditis complicated with cerebral hemorrhage,in order to improve the understanding of infective endocarditis complicated with cerebral hemorrhage.Methods The clinical data of 3 patients with infective endocarditis complicated with cerebral hemorrhage were collected.Combined with the data of 18 cases reported in domestic and foreign literatures,the clinical manifestations,imaging features and bacteriological characteristics of patients were reviewed and discussed.Results The clinical manifestations of 21 patients with infective endocarditis complicated with cerebral hemorrhage were more common with headache,hemiplegia and disturbance of consciousness.Most of them were single or multiple parenchymal hemorrhage.The common position of hematoma was the lobes.Staphylococcus aureus and Streptococcus viridans were the common pathogens,mitral valve involvement was most common.Conclusion Infective endocarditis complicated with cerebral hemorrhage is rare,physician should pay enough attention when patients with infective endocarditis develop neurological symptoms