ABSTRACT
A case of primary infectious endocarditis with the lesion of mitral valve in a pregnant woman is reported The diseases was caused by meticillin-resistant Staphylococcus aureus. Special attention is given to inefficiency of beta-lactame antibiotics against this infection and beneficial effect of daptomycin therapy. This observation confirms literature data about high frequency of thromboembolic complications of S aureus-induced infectious endocarditis due to the production of various coagulases and von Willebrand factor-binding protein by these microorganisms. An increase of coagulation caused by S. aureus is mediated through activation of prothrombin, factor XIII, and fibrin-binding fibronectin. It requires prescription of direct thrombin inhibitor pradax that proved to yield good results in the treatment of our patient. It is concluded that infectious endocarditis in pregnant women is characterized by an atypical clinical picture due to impaired immunity associated with rapid progression of the process after delivery, high frequency of thromboembolic and DIC syndromes.
Subject(s)
Dabigatran/administration & dosage , Daptomycin/administration & dosage , Endocarditis, Bacterial , Methicillin-Resistant Staphylococcus aureus , Mitral Valve , Pregnancy Complications, Cardiovascular , Venous Thromboembolism , Adult , Anti-Bacterial Agents/administration & dosage , Antithrombins/administration & dosage , Echocardiography/methods , Endocarditis, Bacterial/complications , Endocarditis, Bacterial/diagnosis , Endocarditis, Bacterial/drug therapy , Endocarditis, Bacterial/microbiology , Endocarditis, Bacterial/physiopathology , Female , Humans , Methicillin-Resistant Staphylococcus aureus/drug effects , Methicillin-Resistant Staphylococcus aureus/isolation & purification , Mitral Valve/diagnostic imaging , Mitral Valve/pathology , Pregnancy , Pregnancy Complications, Cardiovascular/diagnosis , Pregnancy Complications, Cardiovascular/drug therapy , Pregnancy Complications, Cardiovascular/microbiology , Pregnancy Complications, Cardiovascular/physiopathology , Pregnancy Outcome , Tomography, X-Ray Computed/methods , Treatment Outcome , Venous Thromboembolism/drug therapy , Venous Thromboembolism/etiology , Venous Thromboembolism/physiopathologyABSTRACT
The review of the data available in the literature dedicated to the problems of the diagnosis, clinical picture, and treatment of bronchial asthma (BA) in females during pregnancy. BA is shown to belong to the diseases whose pattern changes during pregnancy and despite that there are a great deal of papers on the above problem, the genesis of these changes has not been determined. Asthmatic attacks during gestation exert a significant negative impact on the development of pregnancy and the fetus; its main cause is hypoxia; however, there is no unambiguous evidence for this; today there are available several hypotheses that are presented in this paper. The data available in the literature show that most investigators consider it necessary to perform medical treatment for these disease; however, its nature has not been defined yet.
