RESUMO
Pneumococcal endocarditis is a very serious and rare clinical entity that results in significant morbidity and high mortality rates. It causes severe disease and is typically seen in alcoholics and immunocompromised patients. Antimicrobial therapy and timely surgery are warranted for optimal management and improving outcomes. We present a case of a previously healthy 31-year-old Hispanic man with bicuspid aortic valve who developed severe bivalvular pneumococcal endocarditis complicated by suppurative pericarditis that was promptly treated with antimicrobial therapy and subsequent aortic valve replacement with initial favorable clinical and hemodynamic improvement.
Assuntos
Endocardite Bacteriana/complicações , Pericardite/complicações , Infecções Pneumocócicas/complicações , Adulto , Valva Aórtica/anormalidades , Valva Aórtica/cirurgia , Endocardite Bacteriana/diagnóstico , Endocardite Bacteriana/cirurgia , Próteses Valvulares Cardíacas , Humanos , Imunocompetência , Masculino , Valva Mitral , Pericardite/diagnóstico , Pericardite/cirurgia , Infecções Pneumocócicas/diagnóstico , Infecções Pneumocócicas/cirurgia , SupuraçãoAssuntos
Infecções Oportunistas Relacionadas com a AIDS/etiologia , Doenças dos Ductos Biliares/diagnóstico por imagem , Colangiografia/efeitos adversos , Giardíase/etiologia , Infecções Oportunistas Relacionadas com a AIDS/diagnóstico , Infecções Oportunistas Relacionadas com a AIDS/tratamento farmacológico , Adulto , Animais , Antiprotozoários/uso terapêutico , Doenças dos Ductos Biliares/complicações , Ductos Biliares Intra-Hepáticos/diagnóstico por imagem , Ductos Biliares Intra-Hepáticos/parasitologia , Ducto Colédoco/diagnóstico por imagem , Ducto Colédoco/parasitologia , Dilatação Patológica , Contaminação de Equipamentos , Seguimentos , Giardia lamblia/isolamento & purificação , Giardíase/diagnóstico , Giardíase/tratamento farmacológico , Humanos , MasculinoRESUMO
Less common and emerging fungal pathogens are often resistant to conventional antifungal therapy and may cause severe morbidity and mortality in immunocompromised hosts. Some Scedosporium species may be completely resistant to antifungal therapy. Hyaline septated filamentous fungi, such as Fusarium species, Acremonium species, Paecilomyces species, and Trichoderma species, are increasingly reported as causing invasive mycoses refractory to amphotericin B therapy. Dematiaceous septated filamentous fungi, such as Bipolaris species may cause pneumonia, sinusitis, and CNS infections that are unresponsive to current medical interventions. Trichosporon spp are resistant to the fungicidal effects of amphotericin B. An increasing number of different members of the class Zygomycetes are reported as causing lethal infections, despite aggressive medical and surgical interventions. Infections due to these and other less common and emergent fungal pathogens will likely continue to develop in the settings of selective anti-fungal pressure, permissive environmental conditions, and an expanding population of immunocompromised hosts.
