-
Case Report
-
Korean J Med. 2014;86(3):349-352. Published online March 1, 2014.
DOI: https://doi.org/10.3904/kjm.2014.86.3.349
- 말기신부전 환자에서 Candida famata에 의해 발생한 심내막염
-
김정관1, 황현철2, 장지연3, 하성은3, 김동휘3, 최범순3
-
1예수병원 신장내과
2현대중앙병원 신장내과
3가톨릭대학교 의과대학 내과학교실
- A Case of Infective Endocarditis in an End-Stage Renal Disease Patient Caused by Candida famata
-
Jeong Gwan Kim1, Hyun Chul Whang2, Ji Yeon Jang3, Seong Eun Ha3, Dong Hwi Kim3, Bum Soon Choi3
-
1Division of Nephrology, Department of Internal Medicine, Presbyterian Medical Center, Jeonju, Korea
2Division of Nephrology, Department of Internal Medicine, Hyundae Jungang General Hospital, Wonju, Korea
3Division of Nephrology, Department of Internal Medicine, The Catholic University of Korea Seoul Saint Mary's Hospital, Seoul, Korea
- Corresponding author: Bum Soon Choi ,Tel: +82-2-2258-1232, Fax: +82-2-532-6537, Email: sooncb@catholic.ac.kr
- Received: May 8, 2013; Revised: May 30, 2013 Accepted: May 31, 2013.
- 혈액투석 중인 만성 신부전 환자에서 발생하는 진균성 심내막염은 일반적 감염성 심내막염보다 발생빈도는 적으나 예후는 좋지 않다. 그렇기 때문에 의심되는 소견을 보이면 경흉부 심장초음파와 함께 경식도 심장초음파의 적극적인 검사로 빠른 진단과 치료가 필요하다.
߽ɾ :혈액 투석; 감염성 심내막염; 캔디다; 혈종
- Abstract
- Infective endocarditis is rare in end-stage renal disease (ESRD) patients, who have a poorer prognosis than the general population. Candida endocarditis is rare and has a poor prognosis among causes of infective endocarditis. A 45-year-old male was admitted with sepsis combined with a hematoma on his right back. Candida famata was cultured in his blood. We treated him with antifungal agents. Echocardiography was performed to identify vegetations and diagnose endocarditis. In this case, surgical therapy was impossible because the patient’s condition had deteriorated. We also administered antibiotics because methicillin-resistant Staphylococcus aureus was cultured from his sputum and a perianal abscess. The symptoms did not improve despite the ongoing treatment. Metabolic acidosis, hypotension, and a decreased state of consciousness developed and he died. We report a rare case of Candida endocarditis in an ESRD patient on hemodialysis. (Korean J Med 2014;86:349-352)
Keywords :Hemodialysis, Infective endocarditis, Candida, Hematoma
