Mustafa OYLUMLU, Abdulkadir YİLDİZ, Mehmet BİLİK, Nihat POLAT, Murat YUKSEL

Bir Hemodiyaliz Hastasında Üç Kapak Tutulumu Olan Endokardit Vakası

On iki aydır immünglobulin A nefropatisi tanısıyla hemodiyaliz yapılan yirmi iki yaşında erkek hasta ateş, terleme ve halsizlik şikayeti ile kardiyoloji kliniğimize yönlendirildi. Hastanın başvurusunda vucut sıcaklığı 38,6°C, kalp hızı 115 atım/dk ve tansiyon arteriel 110/70 mmHg idi. Labaratuvar tetkiklerinde lökosit, eritrosit sedimantasyon hızı ve C-reaktif protein değerleri yüksekti. Mitral, aort ve triküspit kapakta vejetasyon vardı. Kan kültüründe vankomisine duyarlı Enterococus faecalis üredi. Cerrahi operasyonu kabul etmeyen hasta multiorgan disfonksiyonu nedeniyle kaybedildi.

Anahtar Kelimeler:

İnfektif endokardit, kronik böbrek yetersizliği

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A 22 year-old male patient referred to cardiology clinic with complaints of fever, chills and malaise. He had been on haemodialysis for 12 months due to immunoglobulin A nephropathy. On admission his body temperature, pulse rate and blood pressure was 38.6°C, 115 beats/min and 110/70 mmHg, respectively. In the laboratory examination there were leukocyte, C-reactive protein and erythrocyte sedimentation rate elevation. There were vegetations on the mitral, aortic and tricuspid valves. Blood cultures were positive for Enterococcus faecalis which was susceptible to vancomycin. Since the patient did not accept the surgical operation, he died because of multi-organ dysfunction

Keywords:

Infective endocarditis, chronic renal failure,

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Brescia MJ, Cimino JE, Appel K, Hurwich BJ. Chronic hemodialysis using venipuncture and a surgically created arteriovenous fistula. N Engl J Med 1966;275(20):1089-92.
Robinson DL, Fowler VG, Sexton DJ, et al. Bacterial endocarditis in hemodialysis patients. Am J Kidney Dis 1997;30(4):521-4.
Minnaganti VR, Cunha BA. Infections associated with uremia and dialysis. Infect Dis Clin North Am. 2001;15(2):385-406.
Abbott KC, Agodoa LY. Hospitalizations for bacterial endocarditis after initiation of chronic dialysis in the United States. Nephron 2002;91(2):203-9
Hoen B, Alla F, Selton-Suty C, et al. Changing profile of infective endocarditis: results of a 1-year survey in France. JAMA 2002;288(1):75-81.
Marr K. Staphylococcus aureus bacteraemia in patients undergoing haemodialysis. Semin Dial 2000; 13(1):23-29
Spies C, Madison JR, Schatz IJ. Infective Endocarditis in Patients with End-stage Renal Disease: Clinical Presentation and Outcome. Arch Intern Med. 2004;164(1):71-75.
Morokuma H, Minato N, Kamohara K, Minematsu N. Three surgical cases of isolated tricuspid valve infective endocarditis. Ann Thorac Cardiovasc Surg 2010;16(2):134-8.
Maraj S, Jacobs LE, Maraj R, Kotler MN. Bacteremia and infective endocarditis in patients on hemodialysis. Am J Med Sci 2004;327(5):242–9. 129