Severe Anemia in a Case with Chronic Kidney Disease and Mechanical Heart Valve

Mehrdad Jafari Fesharaki, F. Samadian, Marjan Sharifzadeh
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Abstract

Introduction: Infective endocarditis is a serious disease with high morbidity and mortality, especially when associated with renal failure. Anemia is a common finding in chronic kidney disease. Here, we present a case of renal failure and severe anemia with a complicated mechanical heart valve infection with a Delayed diagnosis. Case Presentation: A 68-year-old male patient with a history of chronic kidney disease and metallic aortic valve surgery presented with fever, severe anemia, and about 10-kg weight loss that eventually revealed infective endocarditis in echocardiography with significant valvular leakage, pseudoaneurysm of mitral-aortic intervalvular fibrosa and a fistula to left ventricular outflow tract and sinus Valsalva of the aorta. Conclusions: This case report indicates that anemia, renal failure, and fever of unknown origin can be one of the diagnostic signs of endocarditis. It is important to consider infectious endocarditis in high-risk patients because late diagnosis greatly increases mortality, serious complications, and morbidity.
慢性肾病合并机械心脏瓣膜合并严重贫血1例
感染性心内膜炎是一种高发病率和死亡率的严重疾病,尤其与肾衰竭相关。贫血是慢性肾脏疾病的常见病。在这里,我们提出一个病例肾功能衰竭和严重贫血与复杂的机械心脏瓣膜感染延误诊断。病例介绍:68岁男性患者,有慢性肾脏疾病和金属主动脉瓣手术史,表现为发热,严重贫血,体重减轻约10kg,超声心动图显示感染性心内膜炎,瓣膜明显渗漏,二尖瓣-主动脉间纤维性假性动脉瘤,左心室流出道和主动脉Valsalva窦瘘。结论:本病例报告提示贫血、肾功能衰竭、不明原因发热可作为心内膜炎的诊断征象之一。考虑感染性心内膜炎对高危患者是很重要的,因为晚期诊断会大大增加死亡率、严重并发症和发病率。
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