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Korean J Med > Volume 87(1); 2014 > Article
The Korean Journal of Medicine 2014;87(1): 81-86.
자연판막 심내막염에 동반된 급성 상지 허혈을 치료한 1예
장성필, 최재훈, 양미진, 김홍제, 황철구, 김지하, 한동훈
부산광역시의료원 내과
Acute Upper Limb Ischemia Suspected to Have Originated from Staphylococcus Epidermidis Native Valve Endocarditis
Seong Pil Jang, Jae Hoon Choi, Mi Jin Yang, Hong Je Kim, Cheol Gu Hwang, Ji Ha Kim, Dong Hun Han
Department of Internal Medicine, Busan Medical Center, Busan, Korea
Corresponding Author: Jae Hoon Choi ,Tel: +82-51-507-3000, Fax: +82-51-607-2807, Email: doctorcjh@naver.com
Received: June 5, 2013;   Revised: July 26, 2013;   Accepted: August 26, 2013.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
We report a case of acute upper limb ischemia suspected to have originated from methicillin-resistant Staphylococcus epidermidis native valve endocarditis in a 57-year-old man who had complained of sudden-onset fever and pain in the right hand. 3D computed tomography of the right upper extremity detected a thrombus occluding the brachial artery. Echocardiography showed a large vegetation on the aortic valve. Thus, we suspected, clinically, brachial artery occlusion by septic emboli originating from a large vegetation of the aortic valve. The patient was treated with intravenous antibiotics for the suspected methicillin-resistant Staphylococcus epidermidis-native valve endocarditis with a combination of percutaneous aspiration thromboembolectomy and selective intra-arterial thrombolysis for acute thromboembolic occlusion in the right upper limb. The large vegetation of the aortic valve resolved without surgery and aortic regurgitation improved. The patient recovered uneventfully with no complications, including septic embolism, over the following 11 months.
Keywords: Acute lime ischemia; Native valve endocarditis; Staphylococcus epidermides; Thromboembolism
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