Kırım Kongo Kanamalı Ateşi Ayırıcı Tanısında Staphylococcus aureus’a bağlı İnfektif Endokardit Olgusu

Year 2018, Volume: 8 Issue: 4, 369 - 371, 31.12.2018

Sevil Alkan Çeviker Özgür Günal

https://doi.org/10.16899/gopctd.425142

Abstract

İnfektif endokardit (İE); kalbin iç zarının, kapaklarının veya
damarlarının enfeksiyonu olarak bilinir ve hayatı
tehdit eden bir hastalıktır. IE, kalp kapak hastalığı olmayanlarda çok nadir
görülmekle birlikte, kalp kapak hastalığı bulunanlarda görülme riski artar.
IE’in klinik bulguları ve semptomları çok değişken olabilir. Kırım Kongo
Kanamalı Ateşi vakalarında; trombositopeni, artmış AST, ALT, CK ve LDH
seviyeleri en sık görülen laboratuvar bulgularıdır. Bu olgu sunumunda, 23
yaşında ateş şikayeti ile başvuran ve laboratuar bulgularındaki anormallikler (AST,
ALT, CK ve LDH düzeylerinde yükseklik) nedeniyle Kırım Kongo Kanamalı Ateşi
(KKKA) ön tanısı konulan ve takiplerinde S.aureus’un neden olduğu  İnfektife endokardit tanısı konulan bir erkek
hasta
sunulmuştur. Hastaya komplike IE nedeniyle kalp kapak
replasmanı ameliyatı yapıldı ve tedavi sonrası şifa ile taburcu edildi. Bu olgu
sunumunda İE’in klinik ve laboratuvar bulgularının diğer hastalıkları taklit
edebildiğini ve tüm hastalara ayrıntılı fizik muayene yapılmasının gerektiğini
vurgulamayı amaçladık.

Keywords

İnfektif Endokardit, Staphylococcus aureus, Kırım Kongo Kanamalı Ateşi, Ayırıcı tanı

Infective endocarditis Due to Staphylococcus aureus in the differential diagnosis of Crimean-Congo Hemorrhagic Fever

Abstract

Infective endocarditis(IE), known as an inflammation of the endocardium and
the inner lining of the heart and heartvalves, is a life-threatening disease.
Although IE is very rare in people with no heart valve disease, the risk
increases in those with heart valve disease.The clinical signs and symptoms of
infective endocarditis vary considerably. The diagnosis of infective endocarditis
is made by according to modified Duke criteria. In this case report,we describe
a 23-years old male patient of infective endocarditis misdiagnosed as
Crimean-Congo hemorrhagic fever(CCHF) because of he had thrombocytopenia,
increased AST-ALT, CK and LDH levels in his laboratuary findings.Thrombocytopenia,
increased AST-ALT, CK and LDH levels are the most common laboratory findings in
CCHF cases. The patient who hade preliminary diagnosis of CCHF was referred from
secondary care hospital with fever of two weeks.It was learned that
the patient was previously diagnosed ARA
(Acute Rheumatic Fever) in his history. He was diagnosed as MSSA endocarditis
on the mitral valve and the patient was operated on because of IE. After the treatment
was completed for 6 weeks, the patient was discharged with healing.With this case report we aimed to emphasize that the cases
of infective endocarditis could mimic other
diseases and detailed physical examination should be performed on all patients.

Keywords

Infective endocarditis, Staphylococcus aureus, Crimean-Congo hemorrhagic fever, differential diagnosis

References

• 1.Cahill TJ. Prendergast BD. Infectiveendocarditis. Lancet. 2016 ,27;387(10021):882-93.2.Cahill TJ, Baddour LM, Habib G, Hoen B, Salaun E, Pettersson GB, et al. Challenges in infectiveendocarditis. J Am CollCardiol. 2017;69(3):325–44.3.Demirbağ R, Sade LE, Aydın M, Bozkurt A, Acartürk E. TheTurkishregistry of heartvalvedisease. Türk KardiyolDern Arş. 2013; 41(1): 1-10.4.Ergönül Ö. Viral kanamalı ateşler. In: Willke TA, Söyletir G, Doğanay M, eds. İnfeksiyon Hastalıkları ve Mikrobiyolojisi. İstanbul: Nobel Tıp Kitabevleri, 2008: 1251-65.5. Habib G. Management of infective endocarditis. Heart 2006;92:124-30.6. Li JS, Sexton DJ, Mick N, Nettles R, Fowler VG Jr, Ryan T, Bashore T, et al. Proposed modifications to the Duke criteria for the diagnosis of infective endocarditis. Clin Infect Dis 2000;30:633–8.7. Authors/Task Force Members, Habib G, Lancellotti P, Antunes MJ, Bongiorni MG, Casalta JP, Del Zotti F, et al. 2015 ESC Guidelines for the management of infective endocarditis: The Task Force for the Management of Infective Endocarditis of the European Society of Cardiology (ESC)Endorsed by: European Association for Cardio-Thoracic Surgery (EACTS), the European Association of Nuclear Medicine (EANM). Eur Heart J 2015;36:3075–128.8. Nadji GRJ, Coviaux F, Mirode AA, Brahim A, Enriquez-Sarano M, Tribouilloy C. Comparison of clinical and morphological characteristics of Staphylococcus aureus endocarditis with endocarditis caused by other pathogens. Heart. 2005;9:7.9. Karchmer AW. Infective endocarditis In Heart Disease A Textbook of Cardiovascular Medicine. Zipes DP, Libby P, Bonow RO, Braunwald E. (Eds). 7th Edition, Elsevier Saunders. 2005; pp:1633-165810.Di Salvo G, Habib G, Pergola V et al. Echocardiography predicts embolic events in infective endocarditis. J Am Coll Cardiol 2001; 37:1069-1076.