全結腸型 Hirschsprung 氏病に伴う壊死性腸炎治療中に真菌性心内膜炎による三尖弁閉塞を来した1例

概要

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We experienced a rare case of tricuspid valve obstruction secondary to Candida endocarditis. The neonate on the forth day of age was admitted to our hospital for vomitting and abdominal distension. Operative findings suggested total colon agangliosis with severe enterocolitis. She felt in a critical state of panperitonitis following multiple perforation of the intestine, sepsis and DIC after the operation. She recovered from her septic state with massive resection of intestine, drainage operation, broad spectrum antibiotics therapy, total parenteral nutrition via a central venous catheter and exchange blood transfusion. But on the 58th day of age, she developed severe hypoxemia and positive blood culture of Candida. Two dimensional echocardiography indicated tricuspid valve obstruction with large ball-like lesion and severe right-to-left shunt at the atrial level. Autopsy findings revealed Candida endocarditis on the tricuspid valve. In this case report, diagnosis and treatment of mycotic endocarditis of critically ill children were also discussed.
日本小児外科学会の論文
1988-02-20