人工弁置換術後の感染性心内膜炎を疑わせた粟粒結核の2例

Two cases with miliary tuberculosis following prosthetic valve replacement

　人工弁置換術後，遠隔期に発生する発熱は感染性心内膜炎（Prosthetic valve endocarditis；PVE）を念頭におかねばならないがその確定診断は難しく，対策に苦慮することが多い。今回我々は大動脈弁人工弁置換術後の遠隔期にPVEを疑いながら確定診断が得られず，死後剖検で粟粒結核と診断された2例を経験したので報告する。

Pyrexia which occurs at late stage after prosthetic heart valve replacement must be suspected to be caused by prosthetic valve endocarditis (PVE). However, since confirmatory diagnosis is difficult, we are concerned about the treatment for so many cases. We encounted two cases who were suspected PVE at late stage after prosthetic aortic valve re-placement and diagnosed miliary tuberculosis at autopsy. Here, we present a report of the two cases.