Enfektif endokardit tanısında vegetasyon varlığının görüntülenmesi kritik önem taşır. Kılavuzlar bu amaçla ekokardiyografi, bilgisayarlı tomografi (BT) ve nükleer görüntüleme yöntemlerini önermektedir. Bu bildiride bir fungal endokardit vakası sunulmuştur. Olgumuz, 45 yaşında endüstriyel bir kaza sonucu mekanik ventilatöre bağlı ve santral venöz kateter ile takip edilen erkek hastaydı. Hastanın daha öncesinde kapak hastalığı öyküsü yoktur. Tekrarlayan ateşleri ve dispnesi olan hastaya ekokardiyografi yapılmıştır. Fungal endokardit tanısı alan hastaya antifungal tedavi başlanmış fakat tedaviye rağmen vejetasyon büyüdüğü için kapak cerrahisi planlanmıştır. Ameliyat öncesi yapılan koroner anjiografi esnasında aort kapak üzerindeki vegetasyon floroskopik olarak da izlenebilmiştir. Hasta tanıdan dört hafta sonra ameliyat edildi ve ameliyattan sekiz hafta sonra tam iyileşme sağlanarak taburcu edildi. Literatür taramamızda floroskopi altında vegetasyon izlenildiğine dair bildirime rastlanmamıştır. Elde ettiğimiz verilere göre bu bildiri bir vegetasyonun floroskopik olarak görüldüğünü gösteren ilk bildiridir.
Verdiği manevi desteğinden dolayı Nurullah HATİPOĞLU' na teşekkür ederiz.
References
Murdoch DR, Corey GR, Hoen B, Miró JM, Fowler VG Jr, Bayer AS, et al. Clinical presentation, etiology, and outcome of infective endocarditis in the 21st century: the International Collaboration on Endocarditis-Prospective Cohort Study. Arch Intern Med. 2009; 169(5): 463-473.
Pierrotti LC, Baddour L M. Fungal Endocarditis, 1995–2000. Chest 2000; 122(1): 302–310.
Rubinstein E, Lang R. Fungal endocarditis. Eur Heart J. 1995; 16: 84-89.
Habib G, Lancellotti P, Antunes MJ, Bongiorni MG, Casalta JP, Del Zotti F, et al. ESC Guidelines for the management of infective endocarditis:The Task Force for the Management of Infective Endocarditis of the European Society of Cardiology (ESC)Endorsed by:European Association for Cardio-Thoracic Surgery (EACTS), the European Association of Nuclear Medicine (EANM). Eur Heart J 2015; 36(44): 3075–3128.
Gahide G, Bommart S, Demaria R, Sportouch C, Dambia H, Albat B, et al. Preoperative evaluation in aortic endocarditis: findings on cardiac CT. AJRAm J Roentgenol. 2010; 194(3): 574–578.
Chaosuwannakit N, Makarawate P. Value of cardiac computed tomography angiography in pre-operative assessment of infective endocarditis. J Cardiothorac Surg. 2019; 14: 56.
Vegetation image in fluoroscopy: A case report
Year 2020,
Volume: 42 Issue: 2, 216 - 218, 21.07.2020
Imaging of the presence of vegetation is critical in the diagnosis of infective endocarditis. Guidelines recommend echocardiography, computed tomography (CT) and nuclear imaging methods for this purpose. In this paper, a case of fungal endocarditis is presented. Our case was a 45-year-old male patient who was connected to mechanical ventilator as a result of industrial accident and followed with central venous catheter. The patient had no previous history of valve disease. Echocardiography was performed on the patient with recurrent fever and dyspnea. Antifungal treatment was started for the patient who was diagnosed with fungal endocarditis, but valve surgery was planned since vegetation grew despite the treatment. During preoperative coronary angiography, vegetation on the aortic valve could also be monitored by fluoroscopy. The patient was operated four weeks after diagnosis and was discharged eight weeks after operation with complete recovery. In our literature review, there were no reports regarding vegetation monitored under fluoroscopy. According to the data we obtained, this paper is the first report showing that a vegetation is seen by fluoroscopy.
Murdoch DR, Corey GR, Hoen B, Miró JM, Fowler VG Jr, Bayer AS, et al. Clinical presentation, etiology, and outcome of infective endocarditis in the 21st century: the International Collaboration on Endocarditis-Prospective Cohort Study. Arch Intern Med. 2009; 169(5): 463-473.
Pierrotti LC, Baddour L M. Fungal Endocarditis, 1995–2000. Chest 2000; 122(1): 302–310.
Rubinstein E, Lang R. Fungal endocarditis. Eur Heart J. 1995; 16: 84-89.
Habib G, Lancellotti P, Antunes MJ, Bongiorni MG, Casalta JP, Del Zotti F, et al. ESC Guidelines for the management of infective endocarditis:The Task Force for the Management of Infective Endocarditis of the European Society of Cardiology (ESC)Endorsed by:European Association for Cardio-Thoracic Surgery (EACTS), the European Association of Nuclear Medicine (EANM). Eur Heart J 2015; 36(44): 3075–3128.
Gahide G, Bommart S, Demaria R, Sportouch C, Dambia H, Albat B, et al. Preoperative evaluation in aortic endocarditis: findings on cardiac CT. AJRAm J Roentgenol. 2010; 194(3): 574–578.
Chaosuwannakit N, Makarawate P. Value of cardiac computed tomography angiography in pre-operative assessment of infective endocarditis. J Cardiothorac Surg. 2019; 14: 56.