覚醒剤常用者に発症した三尖弁位感染性心内膜炎の1治験例  [in Japanese] Successful Repair of Tricuspid Valve Endocarditis in a Drug Abuser  [in Japanese]

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Abstract

薬物使用歴のある成人に発症した,三尖弁位感染性心内膜炎に対して,弁形成術を施行した1例を報告する.症例は20歳男性.発熱を主訴に受診し,肺膿瘍を合併した三尖弁位感染性心内膜炎と診断され,抗生剤による加療が行われたが,炎症所見の遷延を認めた.血液培養から,黄色ブドウ球菌を検出,心臓超音波検査では三尖弁に疣贅と三尖弁閉鎖不全を認めた.肘部に多数の注射痕を認め,詳細な問診を行ったところ,覚醒剤の自己注射歴が判明した.抗生剤治療に抵抗性の感染性心内膜炎に対して,三尖弁形成術を行った.経過は良好で,術後2週間で独歩退院したが,予定された外来の受診はなく,術後も覚醒剤所持で逮捕されている.覚醒剤の再使用,術後の投薬管理の点から術式に一考を要した.

This case report describes a 20-year-old man, who was a drug abuser, and was treated surgically for tricuspid valve endocarditis. He presented with fever, caused by tricuspid valve endocarditis with a lung abscess. Blood culture detected <i>Staphylococcus aureus </i>and cardiac ultrasonography showed tricuspid insufficiency and tricuspid valve vegetation. He was treated with intravenous antibacterial agents, but the inflammation signs did not improve. He had a large number of puncture scars, as a consequence of self-injection of drugs in his lower arm. He underwent tricuspid valve plasty, and recovered successfully. He was discharged 2 weeks after surgery, and we instructed him to return for follow-up examination in our hospital. However, he did not return to our hospital because he was arrested for drug possession. In such cases, it is necessary to consider the operative method relative to reuse of drugs in the postoperative management of medication.

Journal

  • Japanese Journal of Cardiovascular Surgery

    Japanese Journal of Cardiovascular Surgery 42(2), 120-123, 2013

    The Japanese Society for Cardiovascular Surgery

Codes

  • NII Article ID (NAID)
    130004887125
  • Text Lang
    JPN
  • ISSN
    0285-1474
  • Data Source
    J-STAGE 
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