Infectious endocarditis in a patient with a transplanted kidney on a conventional hemodialysis

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Infectious endocarditis remains challenging to diagnose, especially for patients with no apparent clinical symptoms. The presented clinical case describes a rapid progression of sepsis and challenges in treating a patient with risk factors, including undergoing immunosuppressive therapy due to a transplanted kidney, renal failure and the need for conventional dialysis. The case report highlights the significance of frequent monitoring of patients with the described risk factors, and emphasises the critical role of adopting more aggressive treatment strategies during the initial phases of the disease.

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作者简介

Anna Kozlova

N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia

编辑信件的主要联系方式.
Email: annakoz15@mail.ru
ORCID iD: 0009-0002-4321-1927

Assistant at the Department of Hospital Therapy named after P.E. Lukomsky of the Faculty of General Medicine

俄罗斯联邦, Moscow

Yulia Agafonova

N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia

Email: yuliaagaf2000@mail.ru
ORCID iD: 0009-0007-4877-9569

6th year student of the Faculty of General Medicine

俄罗斯联邦, Moscow

Roman Timofeev

N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia

Email: Timofrg@yandex.ru
ORCID iD: 0009-0000-2468-2200

6th year student of the Faculty of General Medicine

俄罗斯联邦, Moscow

Vasily Mayorov

O.M. Filatov Municipal Clinical Hospital No. 15 of the Department of Healthcare of Moscow

Email: Vasso88-88@bk.ru

Head of the Department of Nephrology

俄罗斯联邦, Moscow

Elena Merkusheva

O.M. Filatov Municipal Clinical Hospital No. 15 of the Department of Healthcare of Moscow

Email: lucky666_92@mail.ru

Nephrologist at the Department of Nephrology

俄罗斯联邦, Moscow

Valentin Kokorin

N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia

Email: valentinkokorin@yahoo.com
ORCID iD: 0000-0001-8614-6542

MD, Associate Professor, Professor the Department of Hospital Therapy named after P.E. Lukomsky of the Faculty of General Medicine

俄罗斯联邦, Moscow

参考

  1. McCreery R.J., Florescu D.F., Kalil A.C. Sepsis in immunocompromised patients without human immunodeficiency virus. J Infect Dis. 2020; 222(Suppl 2): S156–65. https://dx.doi.org/10.1093/infdis/jiaa320.
  2. Демин А.А., Кобалава Ж.Д., Скопин И.И. с соавт. Инфекционный эндокардит и инфекция внутрисердечных устройств у взрослых. Клинические рекомендации 2021. Российский кардиологический журнал. 2022; 27(10): 113–192. [Demin A.A., Kobalava Zh.D., Skopin I.I. et al. Infectious endocarditis and infection of intracardiac devices in adults. Clinical guidelines 2021. Rossiyskiy kardiologicheskiy zhurnal = Russian Journal of Cardiology. 2022; 27(10): 113–192 (In Russ.)]. https://dx.doi.org/10.15829/1560-4071-2022-5233. EDN: DCXUXV.
  3. Тюрин В.П., Шевченко Ю.Л. Инфекционные эндокардиты: руководство. 2-е изд., перераб. и доп. М.: ГЭОТАР-Медиа. 2013; 368 с. [Tyurin V.P., Shevchenko Yu.L. Infective endocarditis: A guide. 2nd ed., revised and additional. Moscow: GEOTAR-Media. 2013; 368 pp. (In Russ.)]. ISBN: 978-5-9704-2554-1.
  4. Chaudry M.S., Carlson N., Gislason G.H. et al. Risk of infective endocarditis in patients with end stage renal disease. Clin J Am Soc Nephrol. 2017; 12(11): 1814–22. https://dx.doi.org/10.2215/CJN.02320317.
  5. Nucifora G., Badano L.P., Viale P. et al. Infective endocarditis in chronic haemodialysis patients: An increasing clinical challenge. Eur Heart J. 2007; 28(19): 2307–12. https://dx.doi.org/10.1093/eurheartj/ehm278.
  6. Hoen B., Paul-Dauphin A., Hestin D., Kessler M. EPIBACDIAL: A multicenter prospective study of risk factors for bacteremia in chronic hemodialysis patients. JASN. 1998; 9(5): 869–76. https://dx.doi.org/10.1681/ASN.V95869.
  7. Hoen B., Alla F., Selton-Suty C. et al.; Association pour l’Etude et la Prévention de l’Endocardite Infectieuse (AEPEI) Study Group. Changing profile of infective endocarditis: Results of a 1-year survey in France. JAMA. 2002; 288(1): 75–81. https://dx.doi.org/10.1001/jama.288.1.75.
  8. Pericas J.M., Llopis J., Jimenez-Exposito M.J. et al. Infective endocarditis in patients on chronic hemodialysis. J Am Coll Cardiol. 2021; 77(13): 1629–40. https://dx.doi.org/10.1016/j.jacc.2021.02.014.
  9. Raza S., Hussain S.T., Rajeswaran J. et al. Value of surgery for infective endocarditis in dialysis patients. J Thorac Cardiovasc Surg. 2017; 154(1): 61–70.e6. https://dx.doi.org/10.1016/j.jtcvs.2017.02.063.

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2. Fig. 1. Multispiral computed tomography of the chest organs of patient M.

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3. Fig. 2. Magnetic resonance imaging of the thoracic spine of patient M.: spondylodiscitis at the level of the Th8-Th9 segment

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