Viêm nội tâm mạc, viêm cơ tim và viêm màng ngoài tim do Aspergillus gây ra trong bối cảnh hoại tử mỡ

C. Sergi1, W. J. Hofmann1, P. Sinn1, P. A. Schnabel1, H. F. Otto1, J. Weitz2, G. Otto2, A. Eckart3
1Institute of Pathology, University of Heidelberg, Heidelberg, Germany
2Department of Surgery, University of Heidelberg, Heidelberg, Germany
3Institute of Neuropathology, University of Heidelberg, Heidelberg ,Germany

Tóm tắt

Bài báo mô tả một bệnh nhân mắc viêm nội tâm mạc, viêm cơ tim và viêm màng ngoài tim do Aspergillus. Một người đàn ông 55 tuổi đã phát triển viêm hoại tử cân cơ ở thành bụng dưới, vùng chậu và đùi phải. Mặc dù đã thực hiện xử lý phẫu thuật triệt để và điều trị kháng sinh tích cực, bệnh nhân đã tử vong do suy đa cơ quan. Khám nghiệm tử thi cho thấy có viêm nội tâm mạc huyết khối do Aspergillus, viêm cơ tim và viêm màng ngoài tim, viêm phổi nấm hoại tử cấp tính và sự lan tỏa nấm đến não, thận và tuyến giáp. Một cuộc tổng quan tài liệu cho thấy rằng trong trường hợp không có phẫu thuật tim hở, viêm nội tâm mạc và viêm cơ tim do Aspergillus rất hiếm gặp.

Từ khóa

#Aspergillus #viêm nội tâm mạc #viêm cơ tim #viêm màng ngoài tim #hoại tử mỡ

Tài liệu tham khảo

Aisenfarb JC, Dupre-Minet M, Asseman P, Chammas E, Lesenne M, Thery C (1993) Endocardite aspergillaire primitive. Arch Mal Coeur Vaiss 86: 259–261 Blanc P, Hoffman P, Michaels JF, Bernard E, Vinti H, Morand P, Loubière R (1990) L'atteinte cardiaque des patients porteurs du virus de l'immunosuppression humaine (VIH). A propos de 38 cas. Ann Cardiol Angeiol (Paris) 39: 519–525 Bogner JR, Luftl S, Middeke M, Spengel F (1990) Erfolgreiche medikamentöse Therapie einer Aspergillen-Endokarditis. Dtsch Med Wochenschr 115: 1833–1837 Buchbinder NA, Roberts WC (1972) Active infective endocarditis confined to mural endocarditis. A study of six necropsy patients. Arch Pathol 93: 435–440 Caplan HI, Frisch E, Hoghton JD, Climo MS, Natsios GA (1968) Aspergillus fumigatus endocarditis. Report of a case diagnosed during life. Ann Intern Med 68: 378–385 Cohen DM, Goggans EA (1971) Sclerosing mediastinitis and terminal valvular endocarditis caused by fungus suggestive of Aspergillus species. Am J Clin Pathol 56: 91–96 Cortet B, Richard R, Deprez X, Lucet L, Flipo RM, Le Loët X, Duquesnoy B, Delcambre B (1994) Aspergillus spondylodiscitis: successful conservative treatment in 9 cases. J Rheumatol 21: 1287–1291 Cox JN, di Dio F, Pizzolato GP, Lerch R, Pochon N (1990) Aspergillus endocarditis and myocarditis in a patient with the acquired immunodeficiency syndrome (AIDS). A review of the literature. Virchows Arch [A] 417: 255–259 Falsey AR, Goldsticker RD, Ahern MJ (1990) Fatal subcutaneous aspergillosis following necrotizing fasciitis: a case report. Yale J Biol Med 63: 9–13 Garcia Gomez R, Valdespino Estrada A, Lopez Ortiz R (1981) Endocarditis por Aspergillus. Informe de un caso tratado quirurgicamente con exito. Arch Inst Cardiol Mex 51: 549–553 Grigor'ev BA (1984) Gerneralized aspergillosis (in Russian). Arkh Patol 46: 63–66 Henochowicz S, Mustafa M, Lawrinson WE, Pistole M, Lindsay J (1985) Cardiac aspergillosis in acquired immune deficiency syndrome. Am J Cardiol 55: 1239–1240 Hofman P, Gari-Toussaint M, Bernard E, Michiels JF, Gibelin P, Le Fichoux Y, Morand P, Loubiere R (1992) Myocardites fungiques au cours du syndrome d'immunodéficience acquise. Arch Mal Coeur Vaiss 85: 203–208 Hurley J, McGovern E (1994) Rupture of a sinus of Valsalva aneurysm due to Aspergillus endocarditis. J Cardiovasc Surg 35: 75–77 Kaplan R, Duncalf D, Cizmar S (1981) Aspergillus pancarditis and cardiac arrest during anesthesia. Anesth Analg 60: 440–444 Kirschstein RL, Sidransky H (1956) Mycotic endocarditis of the tricuspid valve due to Aspergillus flavus. Arch Pathol 62: 103–106 Kotwal MR, Rinchhen CZ (1981) Primary aspergillosis with multisystem dissemination (letter). Lancet I: 562 Kuijer PMM, Kuijper EJ, Tweel JG van den, Lelie J van der (1992) Aspergillus fumigatus, a rare cause of fatal coronary artery occlusion. Infection 20: 45–47 Light JT Jr, Hendrickson M, Sholes WM, Portnoy DA, Bell WH III, Kerstein MD (1991) Acute aortic occlusion secondary to Aspergillus endocarditis in an intravenous drug abuser. Ann Vasc Surg 5: 271–275 Luke JL, Bolande RP, Gross S (1963) Generalized aspergillosis and Aspergillus endocarditis in infancy. Report of a case. Pediatrics 31: 115–122 Medical Staff Conference (1971) The spectrum of fungal endocarditis. Calif Med 115: 34–40 Meyer RD, Fox ML (1973) Aspergillus endocarditis. Therapeutic failure of amphotericine B. Arch Intern Med 132: 102–106 Mikulski SM, Love LJ, Bergquist EJ, Hargadon MT, Applefeld MM, Mergner W (1979) Aspergillus vegetative endocarditis and complete heart block in a patient with acute leukemia. Chest 76: 473–476 Mullen P, Jude C, Borkon M, Porterfield J, Walsh TJ (1986) Aspergillus mural endocarditis. Clinical and echocardiographic diagnosis. Chest 90: 451–452 Nishiura T, Miyazaki Y, Oritani K, Tominaga N, Tomiyama Y, Katagiri S, Kanayama Y, Yonezawa T, Tarui S, Yamada T, Sakurai M, Kume H, Okudaira M (1986) Aspergillus vegetative endocarditis complicated with schizocytic hemolytic anemia in a patient with acute lymphocytic leukemia. Acta haematol 76: 60–62 Patiño JF, Castro D (1991) Necrotizing lesions of soft tissues: a review. World J Surg 15: 235–239 Peterson SP, Schiller N, Stricker RB (1984) Failure of two-dimensional echocardiography to detect Aspergillus endocarditis. Chest 85: 291–294 Ramos Fernandez V, Prieto Rodriguez M, Paradis Alos A, Lopez Chulia F, Salom Fuster JV, Vera Sempere FJ (1993) Aspergilosis diseminada angioinvasiva: diagnostico necropsico en pacientes leucosicos. An Med Interna 10: 337–340 Rea WJ, Wyrick WJ Jr (1970) Necrotizing fasciitis. Ann Surg 172: 957–964 Ribera JM, Ferrer O, Blade J, Valls V, Carreras E, Granena A, Montserrat E, Rozman C (1983) Endocarditis por Aspergillus en un paciente con leucemia aguda linfoblastica en remision. Med Clin (Barc) 81: 436–439 Riou B, Rimailho A, Sinico M, Richard C, Auzepy P (1985) Endocardite droite au cours d'une aspergillose disseminée. Ann Med Interne (Paris) 136: 398–400 Rouse TM, Malangoni MA, Schulte WJ (1982) Necrotizing fasciitis: a preventable disaster. Surgery 92: 765–770 Rubinstein E, Lang R (1995) Fungal endocarditis. Eur Heart J 16: 84–89 Rubinstein E, Noriega ER, Simberkoff MS, Holzman R, Rahal JJ (1975) Fungal endocarditis: analysis of 24 cases and review of the literature. Medicine (Baltimore) 54: 331–344 Schwartz DA (1989) Aspergillus pancarditis following bone marrow transplantation for chronic myelogeneous leukemia. Chest 95: 1338–1339 Stevens DL (1992) Invasive group A streptococcus infections. Clin Infect Dis 14: 2–11 Swensson EE, Willman VL, Peterson GJ (1986) Acute aortic occlusion from aspergillosis in a healthy patient with survival. J Vasc Surg 4: 187–191 Vasin VA, Papkov VG, Libiiainen TP, Vasin IV (1987) Aspergillotic septic endocarditis of the mitral and trigeminal valves as a complication of silicotuberculosis (in Russian). Arkh Patol 49: 50–53 Vishniavsky N, Sagar KB, Markowitz SM (1983) Aspergillus fumigatus endocarditis on a normal heart valve. South Med J 76: 506–508 Walsh TJ, Hutchins GM (1979) Aspergillus mural endocarditis. Am J Clin Pathol 71: 640–644 Welsh RA, Buchness JM (1955) Aspergillus endocarditis, myocarditis and lung abscesses. Report of a case. Am J Clin Pathol 25: 782–786 Woods GL, Wood RP, Shaw BW Jr (1989) Aspergillus endocarditis in patients without prior cardiovascular surgery: report of a case in a liver transplant recipient and review. Rev Infect Dis 11: 263–272 Zimmerman LE (1950) Candida and Aspergillus endocarditis with comments on the role of antibiotics in dissemination of fungus disease. Arch Pathol 50: 591–605 Zimmerman LE (1955) Fatal fungus infections complicating other diseases. Am J Clin Pathol of 25: 46–65