Infective endocarditis and acute purulent pericarditis in a patient with hyperglycemia.
A diabetic patient was admitted to our hospital for infective endocarditis with acute purulent pericarditis and diabetic ketoacidosis. Echocardiography revealed attachment of vegetation to the chordae tendineae in the left ventricle and pericaridial effusion. The vegetation was enlarged and pendulated for a few days despite maximal antimicrobial therapy. Surgical resection was desirable to decrease the risk of embolic complications and cardiovascular collapse. We could not open the heart because of accumulation of purulent pericardial fluid, and right renal infarction was complicated. We believe that the immunocompromised and hypercoagulable state due to diabetes caused these conditions.
Oki
Kenji
K
Department of Internal Medicine, National Hospital Organization Higashihiroshima Medical Center, Jike, Saijo.
Matsuura
Wataru
W
Saito
Yasuhiro
Y
Ono
Yujiro
Y
Yanagihara
Kaoru
K
Sueshiro
Masafumi
M
Morita
Satoru
S
Koide
Junko
J
Maeda
Akihiro
A
D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D004452:Echocardiography; D004562:Electrocardiography; D004697:Endocarditis, Bacterial / Q000000981:diagnostic imaging / Q000209:etiology* / Q000382:microbiology; D005500:Follow-Up Studies; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000150:complications* / Q000276:immunology; D008297:Male; D010490:Pericardial Effusion / Q000175:diagnosis / Q000209:etiology / Q000382:microbiology; D010494:Pericarditis, Constrictive / Q000175:diagnosis / Q000209:etiology* / Q000382:microbiology; D012720:Severity of Illness Index; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000209:etiology / Q000382:microbiology; D013211:Staphylococcus aureus / Q000302:isolation & purification; D013290:Streptococcal Infections / Q000175:diagnosis / Q000209:etiology / Q000382:microbiology; D013291:Streptococcus / Q000302:isolation & purification; D013492:Suppuration
D001786:Blood Glucose