奥西林致嗜酸性心肌炎的成功治疗及文献综述

Q4 Medicine

JACC. Case reports Pub Date : 2025-10-08 DOI:10.1016/j.jaccas.2025.105297

Arnold Gan MD , Morgan Burke MD , Eric Yang MD , Tiffany Lien MD , Khalida Arif MD , Maxine Stachel MD

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引用次数: 0

摘要

背景：许多药物与嗜酸性心肌炎（EM）的发生有关，尤其是抗精神病药物和细胞毒性药物。抗生素引起的EM，在文献中很少报道，具有很高的死亡率。病例总结：一名56岁男性，有非典型溶血性尿毒症综合征病史，因甲氧西林敏感金黄色葡萄球菌菌血症而完成奥西林治疗后出现急性心力衰竭。通过心内膜肌活检确定抗生素性EM的诊断，患者经大剂量类固醇治疗后完全恢复。及时诊断和早期类固醇治疗对于降低抗生素引起的EM患者的死亡率至关重要。多学科讨论至关重要，制定临床评分标准以识别高危患者可能有助于临床医生进行早期心内膜活检以加快诊断。抗生素引起的EM极为罕见，但当急性心力衰竭伴有全身炎症症状时应予以怀疑。

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Successful Management of Oxacillin-Induced Eosinophilic Myocarditis and Review of the Literature

Background

Numerous medications have been implicated in precipitating eosinophilic myocarditis (EM), particularly antipsychotics and cytotoxic drugs. Antibiotic-induced EM, scarcely reported in the literature, carries a high mortality rate.

Case Summary

A 56-year-old man with a history of atypical hemolytic uremic syndrome presented with acute heart failure after completing oxacillin treatment for methicillin-susceptible Staphylococcus aureus bacteremia. Diagnosis of antibiotic-induced EM was established with endomyocardial biopsy, and the patient made full recovery with high-dose steroid treatment.

Review Summary

Prompt diagnosis and early steroid treatment is essential in reducing mortality in patients with antibiotic-induced EM. Multidisciplinary discussion is vital, and development of clinical scoring criteria to identify high-risk patients may assist clinicians in pursuing early endomyocardial biopsy to expedite diagnosis.