篇名 | Whether the Valve or the Septic Embolus Is Actively Infectious: A Possible Role of Gallium-67 Scan in a Patient of Infective Endocarditis Complicated with Septic Emboli |
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卷期 | 15:3 |
並列篇名 | 區別心臟瓣膜或菌塊栓塞確實在感染中:鎵-67掃描在心內膜炎合併菌塊栓塞患者可扮演的角色 |
作者 | 楊登堯 、 柯毓麟 、 鄭乃仁 、 柯毓賢 、 蔡名峰 |
頁次 | 161-165 |
關鍵字 | infective endocarditis 、 67Ga inflammation scan 、 septic embolism 、 感染性心內膜炎 、 鎵-67炎症掃描 、 菌塊栓塞 |
出刊日期 | 200209 |
我們提出一位患有二尖瓣心內膜炎合併茵塊栓塞到右腳腘動脈的患者。病人在六週有效的抗生素治療後仍持續發燒但是血行動力學狀況穩定。心臟超音波顯示原本在二尖瓣上的菌塊已經消失,臨床現象及超音波和核磁共振血管攝影證實菌塊栓塞到右腳腘動脈。鎵-67掃描顯現出在右腳腘動脈而不是二尖瓣有較強的發炎反應。在栓塞摘除術後,病人的燒就退了。我們認為鎵-67掃描在這個情況下可能可以幫忙找出真正的感染源而避免不必要的心臟手術。
We reported a case of infective endocarditis involving the mitral valve and complicated with septic embolus to the right popliteal artery. After 6 weeks of antibiotic treatment, hemodynamic condition of the patient was stable but fever persisted. Echocardiography showed disappearance of the vegetation that was seen on the initial echocardiogram. Occlusion of the right popliteal artery by septic emboli was suspected by clinical findings and proved by duplex and magnetic resonance angiogram. Gallium-67 (67Ga) scan revealed increased uptake over the right leg but not the heart. Afterembolectomy (without open heart surgery), the fever subsided. This case report suggests the possibility that 67Ga scan may playa role in this situation to find the infectious focus and avoid unnecessary open heart surgery.