| Japanese |
|---|
| Title | 細菌性心内膜炎の疣贅を経食道心エコーを用いて経時的に観察した1症例 |
|---|
| Subtitle | 学生投稿症例報告 |
|---|
| Authors | 沼田有里佳*, 坪敏仁**, 石原弘規**, 松木明知** |
|---|
| Authors(kana) | |
|---|
| Organization | *弘前大学医学部学生, **弘前大学医学部附属病院集中治療部・麻酔科学教室 |
|---|
| Journal | 循環制御 |
|---|
| Volume | 24 |
|---|
| Number | 1 |
|---|
| Page | 61-65 |
|---|
| Year/Month | 2003/ |
|---|
| Article | 報告 |
|---|
| Publisher | 日本循環制御医学会 |
|---|
| Abstract | 「はじめに」細菌性心内膜炎の診断上心エコーは重要な役割を果たす. 特に経食道心エコーは疣贅の描出に優れた診断精度を有する. しかし疣贅の状態変化を経時的に観察した報告は少ない. 今回は細菌性心内膜炎の1患者で, 経食道心エコーを用いた経時的な観察により, 中枢神経症状変化の原因を疣贅と推定できたので報告する. 「症例」患者：77歳 女性 身長147cm 体重43.7kg 既往歴：糖尿病 家族歴：特記すべきものはない. 現病歴：99年8月15日自宅にて事故により熱傷し全身管理のため当集中治療部(ICU)に搬送された. 熱傷範囲は, 頸胸腹部, 背部, 両上下肢であり, III度約30%であった. 入室18日と25日にデブリドマンと植皮術を受け, 入室27日には全身状態が落ち着き, 病棟へ転出された. しかし病棟25日目に発熱が生じ, 動脈血酸素飽和度が低下し, 胸部X線写真にて肺炎と診断された. 病棟入室28日に呼吸管理のため再びICUに搬送された. |
|---|
| Practice | 基礎医学・関連科学 |
|---|
| Keywords | Transesophageal echocardiography, Infective endocarditis |
|---|
| English |
|---|
| Title | Successive Observation of Vegetation in Infective Endocarditis Using Transesophageal Echocardiography − A case report − |
|---|
| Subtitle | |
|---|
| Authors | Yurika Numata*, Toshihito Tsubo**, Hironori Ishihara**, Akitomo Matsuki** |
|---|
| Authors(kana) | |
|---|
| Organization | *Medical student, University of Hirosaki School of Medicine, **Intensive Care Unit and Department of Anesthesiology, University of Hirosaki School of Medicine |
|---|
| Journal | Circulation Control |
|---|
| Volume | 24 |
|---|
| Number | 1 |
|---|
| Page | 61-65 |
|---|
| Year/Month | 2003/ |
|---|
| Article | Report |
|---|
| Publisher | Japan Society of Circulation Control |
|---|
| Abstract | Echocardiographic examination is useful in diagnosis of infective endocarditis, with transesophageal echocardiography (TEE) being more accurate than transthoracic echocardiography. However there are few reports how vegetation changes successively in TEE observation. And central nervous system involvement in conjunction with infective endocarditis typically emerges from septic embolism. The case we described suggests that observation of vegetation with TEE informs us the beginning of cerebral infarction. A 77-year-old woman with a history of third degree burn and diabetes mellitus was admitted to ICU with persistent fever, shortness of breath, and pneumonia. Transthoracic echocardiography detected no vegetation. On the second ICU day, blood culture was positive for methicillin resistant Staphylococcus aureus (MRSA). And on the third ICU day, TEE revealed oscillating mass on the mitral valve, and infective endocarditis was defined according to the Duke's criteria. Head CT scan showed cerebral infarction. On the sixth ICU, TEE showed significant changes in vegetation size before and after sudden pupil dilation. TEE could demonstrate the cause of pupil dilation in this endocarditis patient without CT observation. |
|---|
| Practice | Basic medicine |
|---|
| Keywords | Transesophageal echocardiography, Infective endocarditis |
|---|