Fungal endocarditis after heart prosthetic valve surgery:two case report and literature review on treatment strategies
10.3969/j.issn.1671-9638.2018.11.010
- VernacularTitle:心脏人工瓣膜术后真菌性心内膜炎2例报告及治疗策略文献综述
- Author:
Song YANG
1
;
Bao ZHANG
;
Cui-Ping WANG
;
Wen-Bo ZHANG
;
Bai-Yun TANG
Author Information
1. 中山大学第一附属医院
- Keywords:
heart;
heart prosthetic valve surgery;
fungal endocarditis;
healthcare-associated infection;
treatment strategy
- From:
Chinese Journal of Infection Control
2018;17(11):993-997
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate treatment strategies for fungal endocarditis after heart prosthetic valve surgery. Methods Two cases of severe fungal infection after heart prosthetic valves surgery were analyzed retrospectively, related literatures were reviewed.Results Two patients had fungal endocarditis after surgery,the valve function was affected,patients were hospitalized repeatedly after surgery.In case 1 ,fever occurred 45 days after cardiac sur-gery and patient was returned to the hospital for re-examination,emergency mitral valve replacement was performed under cardiopulmonary bypass,the postoperative vegetation culture suggested Aspergillus flavus.In case 2,the aortic wall vegetation was removed 5 months after heart surgery under cardiopulmonary bypass,pathology of post-operative vegetation suggested mucor.Two patients were promptly removed infection foci through surgery and trea-ted with standard antifungal agents,patient with Aspergillus infection died after rescue,and patient with mucor in-fection was cured,the latter was more powerful in antifungal therapy.Conclusion Prevention is the key to fungal endocarditis after heart prosthetic valve surgery,treatment should be prompt and effective,antifungal agents should be given in sufficient dose and course.
