The Korean Journal of Medicine

The Korean Association of Internal Medicine (대한내과학회)
권호 표지

A case of infective endocarditis presented as cervical spondylodiscitis

경추 추간판염으로 발현된 감염성 심내막염 1 예

Park, Eun-Mi;Kim, Nam-Ho;Kim, Yun-Kyung;Yoo, Nam-Jin;Lee, Eun-Mi;Oh, Seok-Kyu;Jeong, Jin-Won
박은미;김남호;김연경;유남진;이은미;오석규;정진원

  • Published : 20050300
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Abstract

Infective endocarditis is still one of the important fatal diseases, especially with systemic embolic manifestations. The occurrence of spondylodiscitis as a first manifestation of bacterial endocarditis is an uncommon condition. We experienced a case of infective endocarditis which presented as cervical spondylodiscitis. An 80-year-old man admitted because of having a cervical backache and intermittent fever for one month, and he was initially diagnosed as spondylodiscitis by the radiologic study. However, the progression of the disease worsened in spite of undergoing an empirical treatment. After several days, the echocardiogram revealed mitral regurgitation and a vegetation. The blood cultures were positive for Streptococcus viridans. Thus, he was diagnosed as having infective endocarditis. This is the first case of infective endocarditis associated with cervical spondylodiscitis in Korea. Therefore, we report this case with a brief review of the related literatures.

감염성 심내막염에 의한 색전증은 적절한 치료가 따르지 않으면 높은 사망률을 보이는 질환 중 하나이며, 침범 부위에 따라 다양한 임상상을 나타내기 때문에 종종 진단에 어려움이 발생한다. 특히 세균성 심내막염에서 척추 추간판염의 발생은 매우 드물다. 80세 남자가 한달 전부터 발생한 경부통을 주소로 내원하여 경부 추간판염 진단하에 약물 치료 중 증상의 호전이 없이 점점 악화되는 경향을 보이던 중 심부전의 발생, 심초음파상 승모판막 및 대동맥판막에 우종 관찰 그리고 혈액배양에서 Streptococcus viridans가 동정되어 감염성 심내막염으로 진단하였다. 이와 같이 척추 추간판염이 있는 환자에서 지속적인 병의 진행이 관찰되는 경우에는 감염성 심내막염의 가능성을 항상 고려해야한다. 경부 추간판염과 관련한 감염성 심내막염의 증례는 아직 국내에 보고된 바 없어 문헌고찰과 함께 보고하는 바이다.

Keywords

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