肺動脈内疣贅を合併した動脈管開存症に抗菌薬治療と根治術を施行した1例

A Combination Therapy with Antibiotic and Surgical Treatment in a Patient with Patent Ductus Arteriosus with Pulmonary Vegetation：Report of a Case

はじめに　動脈管開存症は先天性心疾患の中でも比較的よく遭遇する疾患であるが，自然閉鎖するか小児期に治療されることが多い．現在は心エコーなどによる診断の進歩，外科的あるいは経カテーテル治療の進歩により成人期に発見されることは少なくなっている．われわれは，未指摘・未治療の動脈管開存症のため肺動脈内に疣贅を形成した成人例に，抗菌薬治療後に動脈管閉鎖術を実施したため文献的考察を加え報告する．

We present a case of a 24-year-old female who presented with a history of fever and back pain. She had no particular medical history and was not taking any medication. Transthoracic echocardiology and computed tomography showed a patent ductus arteriosus with vegetation in the pulmonary artery. She was treated with penicillin G；however, the vegetation embolized into the left pulmonary artery. After the antibiotics was changed to clindamycin and ceftriaxone, the resolution of the lung abscess was shown by computed tomography （CT）. Two months later, a surgical repair of the patent ductus arteriosus was successfully performed. Patent ductus arteriosus-associated infectious endocarditis is relatively rare in adulthood.