无乳链球菌感染性心内膜炎并急性肝衰竭1例

Streptococcus agalactiae infective endocarditis with acute liver failure

目的 探讨无乳链球菌感染性心内膜炎的临床特点和治疗效果。方法 回顾性分析我院收治的1例无乳链球菌感染性心内膜炎合并急性肝衰竭患者的临床表现、诊疗经过及预后。结果 经过积极抗感染、血浆置换和体外循环下赘生物清除、瓣膜置换手术治疗,术后继续予抗感染、抗凝等治疗,患者脏器功能恢复良好,取得了良好的治疗效果,并顺利出院。结论 无乳链球菌感染性心内膜炎可引起急性心力衰竭、急性肝衰竭、急性肾衰竭等多脏器功能不全,合理把握手术时机和准确评估围术期风险有助于提高急危重症感染性心内膜炎患者的救治率。

Objective To explore the clinical characteristics and treatment of infective endocarditis caused by Streptococcus agalactiae.Methods Clinical data and treatment details of a patient with Streptococcus agalactiae endocarditis and acute liver failure admitted to our hospital was analyzed retrospectively.Results After strict anti-biotic therapy and plasmapheresis,the patient received the vegetative removal and valve replacement and finally successfully recovered.Conclusions The diagnosis and treatment of this case suggests that Streptococcus agalactiae infective endocarditis can cause multiple organ dysfunction such as acute heart,liver and renal failure.Optimal timing of surgery and accurate benefits-risk assessment is helpful to improve the prognosis of patients with acute and severe infective endocarditis.