細菌性心內膜炎的臨床觀察

Clinical Observation of Bacterial Endocarditis

王俊雄(Jung-Hshong Wang) ； 呂鴻基(Hung-Chi Lue) ； 陳烱霖(Chiung-Lin Chen)

《Acta Paediatrica Sinica》 10卷4期 (1969/12) Pp. 152-159

摘要

過去3年間，在臺大醫院小兒科有4例細菌性心內膜炎及6例疑細菌性由心內膜炎例，年齡最小者6個月，最大者14歲，男女各佔一半。血液培養結果為陽性者4例，陰性者5例。1例沒有做血液培養。大部份病例無典型的所謂細菌性心內膜炎症狀。每例有先天性心臟病及無法解釋的長期發燒，主要的臨床現象如下：發燒（10例）、心臟雜音（10例）、貧血（6例）、脾腫（2例）、瘀斑（3例）、白血球增多（7例）、血球沉澱速率增高（8例）。陽性培養之4例中，3例為草綠色鏈球菌，1例為白色葡萄球菌。除自動出院而未治療的1例以外，其他9例均接受大量及相當時期的抗生素治療，7例痊癒出院，2例好轉。未治療之1例於出院2日後死亡，其9例均健在，但其中法洛氏四合羣症之1例於10個月後做開心手術，因低心搏出量而死亡。

並列摘要

There were 4 proved and 6 suspected cases of bacterial endocarditis admitted to the Department of Pediatrics, NTUH, during the 3-year period from January 1967 through October 1969. Their ages ranged from 6 months to 14 years. No sexual predilection was seen.
In all cases, congenital heart diseases with prolonged rises of the temperature were noted. Salient symptoms and signs and their frequencies were as follows: fever 100%, heart murmur 100%, loss of appetite 80%, splenomegaly 20%, leukocytosis 70%, elevated ESR 80%, and petechia 30%.
In 9 cases autoblood cultures were carried out, yielding bacteria in 4 cases; Alpha-Streptococci in 3 cases and Staphylococci albus in 1 case.
Except 1 case who was brought home against our advise, all received intensive and long term antibiotics therapy. Seven recovered and 2 improved. The case who was not treated died 2 days after discharge.