Pulmonary endarteritis in a patient with patent ductus arteriosus and a bicuspid aortic valve
Philippine Journal of Internal Medicine
; : 193-195, 2014.
Artigo
em Inglês
| WPRIM (Pacífico Ocidental)
| ID: wpr-632923
Biblioteca responsável:
WPRO
ABSTRACT
BACKGROUND:
Infective endarteritis of the pulmonary artery is an unusual event. While congenital heart disease (CHD) is a risk factor, pulmonary endarteritis as a complication is a rare occurrence especially in the era of antibiotic therapy.CASE PRESENTATION We present a case of a 43-year-old female who initially sought consultation due to fever. Physical examination revealed a continuous murmur at the second intercostal space left parasternal border. There was no petechiae or any other skin lesions noted. Transthoracic two dimensional echocardiogram showed eccentric left ventricular hypertrophy with an ejection fraction of 65%. She had a patent ductus arterioscus as well as a bicuspid aortic valve. Further interrogation revealed a vegetation at the main pulmonary artery. Patient was initially started on ceftriaxone and gentamycin. Blood cultures were positive for coagulase negative Staphylococcus aureus. Ceftriaxone was then shifted to vancomycin, which was completed for 28 days.OUTCOME:
Clinical improvement was accompanied by the disappearance of the vegetation and negative blood cultures. Patient was maintained on enalapril and advised closure of the patent ductus arteriosus. She opted medical management for the time being and was discharge stable and improved.CONCLUSION:
Pulmonary endarteritis is an uncommon complication of CHD. A high index of suspicion must prompt careful evaluation, combining clinical, laboratory and echocardiographic modalitites in order to provide early diagnosis and effective treatment.
Texto completo:
Disponível
Base de dados:
WPRIM (Pacífico Ocidental)
Assunto principal:
Artéria Pulmonar
/
Staphylococcus aureus
/
Ecocardiografia
/
Vancomicina
/
Fatores de Risco
/
Coagulase
/
Hipertrofia Ventricular Esquerda
/
Permeabilidade do Canal Arterial
/
Endarterite
/
Cardiopatias Congênitas
Tipo de estudo:
Estudo de etiologia
/
Fatores de risco
/
Estudo de rastreamento
Limite:
Adulto
/
Feminino
/
Humanos
Idioma:
Inglês
Revista:
Philippine Journal of Internal Medicine
Ano de publicação:
2014
Tipo de documento:
Artigo