资源简介

(共23张PPT)
Cardiovascular system
心血管系统疾病
Section 5
感染性心内膜炎 Infective Endocarditis
含病原体的赘生物
二尖瓣和主动脉瓣、右心的瓣膜（吸毒）
赘生物形状与病原体，治疗有关
急性 ——亚急性
Morphology 病理：
急性感染性心内膜炎
常为脓毒血症或败血症
急性心内膜炎
急性心内膜炎
急性心内膜炎
急性心内膜炎
Acute bacterial endocarditis (ABE)
Acute bacterial endocarditis (ABE)
亚急性感染性心内膜炎
Bacteremia
刷牙
拔牙
导管 Get catheterized
直肠镜或膀胱镜 Proctoscoped or cystoscoped
Colon cancer
静脉注射无菌操作不严
Preexisting cardiac abnormalities
心瓣膜异常
Prosthetic heart valves
人造瓣膜
Intravenous drug abuse
静脉注射毒品
易感因素:
Calcific aortic stenosis
Rheumatic
Congenital
亚急性心内膜炎
亚急性心内膜炎
Subacute bacterial endocarditis (SBE)
Subacute bacterial endocarditis (SBE)
Acute
Subacute
进展快
正常瓣膜
毒力 Virulent organisms
Gross
脆
Microscopic
B+fibrin clots
less inflammation
脓肿
病程长
异常瓣膜
毒力 Virulent and less virulent
Gross
firmer, less destructive
Microscopic
Granulation tissue
Chronic inflammation
Less common
发热
Low grade fever, malaise and weight loss
High fevers, shaking chills
心音改变
脾肿大 Splenomegaly
栓塞
Clinical features 临床病理联系：
肺栓塞 Pulmonary emboli
动脉瘤 Aneurysm
淤点 Petechiae (small hemorrhage)
肾梗死或肾小球 Renal infarcts and glomerulonephritis
充血性心衰 Congestive heart failure
Clinical features 临床病理联系：
Splinter hemorrhage
甲下线状出血
Osler's Nodes
Microabscesses on the epicardial surface
Infective endocarditis is a particularly difficult infection to eradicate because of the avascular nature of the heart valves.
Repeatedblood culture
Detect the changing murmurs

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