Pneumococcal endocarditis: report of a series and review of the literature.
Pneumococcal endocarditis: report of a series and review of the literature.
复制标题
肺炎球菌心内膜炎：系列报告和文献综述。
DOI：
10.1093/clinids/8.5.786
复制
发表时间：
1986
期刊：
影响因子：
--
通讯作者：
Medoff,G
中科院分区：
文献类型：
--
作者：
Powderly,WG;StanleyJr,SL;Medoff,G
自从青霉素出现以来，肺炎球菌性心内膜炎的发病率急剧下降，但仍然是一种潜在的致命感染。从1980年到1984年，有7名患者被诊断为肺炎球菌心内膜炎——4名成人和3名婴儿。除了一名患者进行了脾切除术外，没有可识别的肺炎链球菌感染的易感因素，尽管这三名儿童都小于15个月大。先天性心脏病2例，钙化主动脉疾病1例，二尖瓣脱垂1例。其余三名患者以前心脏正常。7例患者中有5例（71%）发生脑膜炎。5例患者感染治愈：4例仅通过药物治疗（青霉素或万古霉素），5例通过药物治疗加瓣膜清创。两名患者死亡：一名死于顽固性心力衰竭，另一名死于心脏手术并发症。青霉素是治疗肺炎球菌性心内膜炎的有效方法。不能耐受青霉素的病人可以用万古霉素治疗。
Pneumococcal endocarditis has declined sharply in incidence since the advent of penicillin but remains a potentially lethal infection. From 1980 to 1984, pneumococcal endocarditis was diagnosed in seven patients — four adults and three infants. Apart from one patient who had had a splenectomy, there were no recognizable predisposing factors to infection due toStreptococcus pneumoniae, although all three children were younger than 15 months of age. Congenital heart disease was present in two patients, calcific aortic disease in one, and mitral valve prolapse in a fourth. The remaining three patients had previously normal hearts. Meningitis occurred in five (71%) of the seven patients. Five patients were cured of their infection: four by medical therapy alone (penicillin or vancomycin), and a fifth, by medical therapy plus valvular debridement. Two patients died: one with intractable heart failure, and the second, from the complications of cardiac surgery. Penicillin alone is effective therapy for pneumococcal endocarditis. Patients unable to tolerate penicillin may be treated with vancomycin.