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A Case of Infective Endocarditis in whom Increased Size and Amount of Vegetation was Observed Despite Appropriate Antimicrobial Therapy Tsutomu Ohsaka 1 , Takayuki Inomata 1 , Hisahito Shinagawa 1 , Toshimi Koitabashi 1 , Chiharu Noda 1 , Naoyoshi Aoyama 1 , Toru Izumi 1 1Department of Cardio-angiology, Kitasato University School of Medicine Keyword: 感染性心内膜炎 , 適正抗生剤 , 疣腫増大 , infective endocarditis , exacerbation , antimicrobial agents pp.1387-1390
Published Date 2007/12/15
DOI https://doi.org/10.11477/mf.1404100949
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 A 33-year-old male was admitted because of a ventricular septal defect(VSD) complicated with infective endocarditis, diagnosed by the findings of vegetation on the aortic valve and the detection of Streptococcus viridans in blood cultures. Despite the administration of antibiotic agents including PCG and GM confirmed as the appropriate manner of use by the investigation with antimicrobial sensitivity and pharmacokinesis, the inflammatory response in blood increased concomitant with increased size and amount of vegetation and embolic pulmonary abscesses. However, dare to continued the same antibiotic regimen because of the adequacy of these drug use reconfirmed, and thereafter the inflammatory response decreased again. After we undertook surgical repair with aortic valve replacement and patch closure of VSD, the patient improved without any additional complications.

 Some clinical phenomena by which to doubt the adequacy of antibiotic use, such as increased amount of vegetation or persistent increase in the inflammatory response can occur during the course of infective endocarditis. We should always confirm the adequacy of antibiotic use through antimicrobial sensitivity and pharmacokinesis not to misinterpret such seemingly refractory cases with infective endocarditis.


Copyright © 2007, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1200 印刷版ISSN 0452-3458 医学書院

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