title: Mitral valve repair for mitral insufficiency due to infective endocarditis in a patient with idiopathic thrombocytopenic purpura.
abstract: A 63-year-old woman with an 18-year history of idiopathic thrombocytopenic purpura (ITP) was admitted with a persistent fever of unknown cause. Blood culture was positive for alpha-Streptococcus and echocardiography revealed severe mitral regurgitation and vegetation on the mitral valve. After antimicrobial therapy for six weeks, she underwent mitral valve repair using a Cosgrove ring. The platelet count increased and remained stable by perioperative treatment with intravenous high-dose gamma-globulin and platelet transfusion without steroids therapy or splenectomy. The hospital course was uneventful. Perioperative high-dose gamma-globulin therapy and platelet transfusion for the cardiac operation were useful to increase and maintain the platelet count for an ITP patient complicated with infective endocarditis.
authors.affiliation: Department of Surgery, Division of Organ Regeneration Surgery, Faculty of Medicine, Tottori University, Tottori, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Marumoto
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Ashida
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Kuroda
authors.forename: Takafumi
authors.initials: T
authors.lastname: Hamasaki
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kamihira
authors.forename: Shingo
authors.initials: S
authors.lastname: Ishiguro
authors.forename: Shigetsugu
authors.initials: S
authors.lastname: Ohgi
mesh_terms: D004697:Endocarditis, Bacterial / Q000097:blood / Q000150:complications* / Q000628:therapy; D005260:Female; D006801:Humans; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000097:blood / Q000382:microbiology* / Q000601:surgery*; D010976:Platelet Count; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000097:blood / Q000150:complications*; D013290:Streptococcal Infections / Q000097:blood / Q000150:complications* / Q000628:therapy