RESUMO
Thrombus straddling a patent foramen ovale and massive pulmonary embolism is a very rare and life-threatening condition. Optimal management can be controversial because different therapeutic options are available and individual approach based in individual risk is needed. We present a case of a thrombus straddling the patent foramen ovale with massive pulmonary embolism, hemodynamic instability, and upper extremity embolism. We performed surgical pulmonary embolectomy, and venous arterial extracorporeal membrane oxygenation was needed to successfully overcome severe right ventricular impairment and pulmonary injury.
Assuntos
Procedimentos Cirúrgicos Cardíacos/métodos , Embolectomia/métodos , Oxigenação por Membrana Extracorpórea/métodos , Forame Oval Patente/complicações , Ventrículos do Coração , Embolia Pulmonar/complicações , Trombose/etiologia , Ecocardiografia , Ecocardiografia Transesofagiana , Feminino , Forame Oval Patente/diagnóstico , Forame Oval Patente/cirurgia , Cardiopatias/diagnóstico , Cardiopatias/etiologia , Cardiopatias/cirurgia , Humanos , Pessoa de Meia-Idade , Embolia Pulmonar/diagnóstico , Embolia Pulmonar/cirurgia , Trombose/diagnóstico , Trombose/cirurgia , Tomografia Computadorizada por Raios XRESUMO
Daptomycin is a lipopeptide antibiotic active against gram-positive bacteria indicated for the treatment of complicated skin and skin structure infections and Staphylococcus aureus bloodstream infections, including endocarditis. Thrombocytopaenia, but not neutropaenia, is described as a possible or probable adverse effect in the product information. Up to now, two case reports of daptomycin-induced thrombocytopaenia have been published and a single case of neutropaenia associated with prolonged daptomycin use. We report a case of simultaneous thrombocytopaenia and neutropaenia associated with prolonged daptomycin use for a culture-negative endocarditis.
