Interní Med. 2001; 3(5): 235-237

Konzervatívne vyliečená inoperabilná gramnegatívna endokarditída mitrálnej chlopne

MUDr. Ján Červeň, MUDr. Dušan Krkoška CSc
I. Interná klinika MFN, Martin

Published: December 31, 2001  Show citation

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Červeň J, Krkoška D. Konzervatívne vyliečená inoperabilná gramnegatívna endokarditída mitrálnej chlopne. Interní Med. 2001;3(5):235-237.

Bakteriálnu endokarditídu na natívnej chlopni vyvoláva gramnegatívna flóra zriedka (< 5 %). V porovnaní s inými agensami je však významne nižšia kurabilita gramnegatívnej endokarditídy. Prezentujeme prípad 76ročnej pacientky s klinikou endokarditídy, s pozitívnymi hemokultúrami gramnegatívnej paličky Escherichia coli a s echokardiografickým nálezom obrovskej vegetácie na zadnom mitrálnom cípe. Napriek dobrej citlivosti na antibiotiká in vitro bolo ochorenie rezistentné na 4týždňovú cielenú antibiotickú liečbu. Operačná liečba bola kontraindikovaná z extrakardiálnych príčin. Vyliečenie už takmer infaustného stavu sme zaznamenali po ďalšej 5týždňovej liečbe inou kombináciou antibiotík. Na základe analýzy profilu použitých farmák predpokladáme, že rozhodujúcimi boli farmakokinetické parametre jednotlivých antibiotík.

I. Interná klinika MFN, Martin

Infekčná klinika MFN, Martin

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    References

    1. Cohen PS, Maguire HJ, Weinstein L: Infective endocarditis caused by gram-negative bacteria: A review of the literature, 1945-1977. Prog Cardiovasc Dis 1980; 22:205-242. Go to original source... Go to PubMed...
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