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題 名 | Spontaneous Pneumothorax as a Complication of Septic Pulmonary Embolism in an Intravenous Drug User: A Case Report=藥癮患者因敗血性肺栓塞症引起的自發性氣胸 |
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作 者 | 許超群; 黃吉志; 蔡忠榮; 王東衡; 鍾飲文; 黃明賢; | 書刊名 | The Kaohsiung Journal of Medical Sciences |
卷 期 | 22:2 民95.02 |
頁 次 | 頁89-93 |
分類號 | 415.302 |
關鍵詞 | 心內膜炎; 靜脈注射藥癮患者; 氣胸; 肺栓塞; 金黃色葡萄球菌; Endocarditis; Intravenous drug user; Pneumothorax; Pulmonary embolism; Staphylococcus aureus; |
語 文 | 英文(English) |
中文摘要 | 感染性心內膜炎為藥癮患者併發感染時最為嚴重之病症,主要侵犯心臟之三尖瓣並以多發性敗血性肺栓塞來表現。已有許多敗血性肺栓塞症之肺部併發症被提出,但極少報告有自發性氣胸。我們報告的案例為一位海洛因成癮之二十三歲男性,因右心三尖瓣感染性心內膜炎及敗血性肺栓塞入院治療。病患在住院的第七天突發急性呼吸窘迫,並快速導致低血氧。胸部 X光檢查顯示有左側氣胸。由於在此之前病患並未接受任何侵入性處置,顯然此為自發性之氣胸。病患之病況在插入胸管治療後立即穩定下來。其後,病患因瓣膜之贅生物 (vegetation)過大且感染無法以藥物控制而接受了瓣膜置換手術。最後病患存活下來並已出院。自發性氣胸為藥癮患者併發右心心內膜炎與敗血性肺栓塞時可能發生之一嚴重併發症,當此類病患於住院期間發生急性呼吸窘迫時,應立即排除自發性氣胸之可能性。 |
英文摘要 | Infective endocarditis has been the major cause of morbidity and mortality among intravenous drug users (IDUs) with infections, mostly involving the tricuspid valve and presenting multiple septic pulmonary embolisms. Numerous pulmonary complications of septic pulmonary embolism have been described, but only a few have reported spontaneous pneumothorax. Our patient, a 23-year-old heroin addict, was hospitalized for tricuspid endocarditis and septic pulmonary embolism. Acute onset of respiratory distress occurred on his seventh hospital day and rapidly resulted in hypoxemia. Immediate bedside chest radiograph demonstrated left pneumothorax. It was thought to be a spontaneous pneumothorax, because he had not undergone any invasive procedure before the occurrence of pneumothorax. His clinical condition improved after the insertion of an intercostal chest tube. He later underwent surgery to replace the tricuspid valve as a result of the large size of the vegetation and poor control of infection. He ultimately survived. Pneumothorax is a possible lethal complication of septic pulmonary embolism in IDUs with right-sided endocarditis and should be considered in such patients when respiratory distress occurs acutely during their hospitalization. |
本系統中英文摘要資訊取自各篇刊載內容。