Usefulness of Osler's Node Skin Findings in the Diagnosis of Left Atrial Infective Endocarditis
10.4326/jjcvs.37.171
- VernacularTitle:皮膚病変を初発として診断され左房後壁に疣贅を認めた感染性心内膜炎の1例
- Author:
Masayuki Sakaguchi
;
Hitoshi Ohteki
;
Kozo Naitoh
;
Hiroumi Kataoka
;
Takeshi Hakuba
- Publication Type:Journal Article
- From:Japanese Journal of Cardiovascular Surgery
2008;37(3):171-173
- CountryJapan
- Language:Japanese
-
Abstract:
A 26-year-old woman was referred to our hospital with a high fever and thrombocytopenia. The patient was initially given a diagnosis of disseminated intravascular coagulopathy and sepsis. Medial therapy with antibiotic and anticoagulative drug was started in the Department of Internal Medicine. After that, dermatologists identified painful nodular erythema on the face and extremities as Osler's nodes. Echocardiogram revealed a vegetation near the annulus of the mitral valve. The urgent operation was performed. Intraoperative findings showed vegetation on the posterior wall of the left atrium and normal mitral valves. Therefore, vegetation was completely excised with the diseased left atrial wall and the mitral valve was preserved. The defect of the atrial wall was repaired with a pericardial patch. Methicillin-resistant Staphylococcus aureus was detected by blood and tissue bacterial culture. Postoperative echocardiograms showed mild mitral regurgitation. The patient was discharged from hospital after an uneventful postoperative course.
