좌심방이-농양의 수술적 치료 -치험 1예- = Successful Treatment of Left Atrial Auricular Abscess -A case report-

다국어 초록 (Multilingual Abstract)

We reoprt an unusual case of left atrial auricular abscess which was successfully treated by surgical resection, treatment with antibiotics and mediastinal irrigation. A 9-year-old female patient with previous history of urinary tract infection was admitted because of persistent fever. Echocardiography and magnetic resonance imaging revealed massive pericardial effusion and a mass lesion at the left upper cardiac border. Pericardiocentesis isolated Staphylococcus aureus on culture. The patient underwent mass removal under cardiopulmonary bypass. The mass was located within the left atrial auriclular wall with fibropurulent abscess formation inside. Postoperative mediastinal irrigation was performed. Pathologic examination of the mass showed organized thrombi with chronic fibrosing mural endocarditis. She discharged on the 21st postoperative day without complication.

국문 초록 (Abstract)

드문 예인 좌심방이-농양을 수술, 항생제 및 종격동 세척술로 치료한 성공적인 치험 예를 보고하고자 한다. 요로감염의 과거력을 가진 9세 여아가 지속적 발열을 주소로 내원하였다. 심초음파와 자기공명영상에서 다량의 심낭삼출과 좌상심연의 종괴가 관찰되었다. 심낭천자액 균배양에서 포도상구균이 검출되었다. 환아는 체외순환하에 종괴 절제술을 받았는데 종괴는 좌심방이에 위치하였으며 내부는 섬유화농성 농양이 형성되어 있었다. 수술 후 종격동 세척술을 시행하였다. 병리검사소견은 기질화된 혈전을 동반한 섬유화성 벽심내막염이었다. 환아는 특별한 합병증 없이 술 후 21일에 퇴원하였다.

참고문헌 (Reference)

1 "Two unusual cases of mural endocarditis with a review of the literature" 53 : 832-8, 1970

2 "True bacterial mural endocarditis" 59 : 103-5, 1971

3 "Resolution of an infected intracardiac thrombus" 23 : 1118-20, 1989

4 "Myocardial abscess with contained rupture: successful repair" 71 : 1360-1, 2001

5 "Left atrial bacterial mural endocarditis" 99 : 757-9, 1991

6 "Active infective endocarditis confined to mural endocardium" 93 : 435-40, 1972