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감염성 심내막염을 합병한 대동맥-대퇴동맥 간 우회로 인조혈관 겸염 1예

A Case of Aorto-femoral bypass Graft Infection Complicated with Infective Endocarditis

감염과화학요법 2005년 37권 5호 p.292 ~ 297
정동식, 문승환, 최세웅, 이창재, 김경태, 백정환, 정영진, 조광조, 강도영, 이혁,
소속 상세정보
정동식 ( Jung Dong-Sik ) - 동아대학교 의과대학 내과학교실
문승환 ( Moon Seung-Hwan ) - 동아대학교 의과대학 내과학교실
최세웅 ( Choi Se-Woong ) - 동아대학교 의과대학 내과학교실
이창재 ( Lee Chang-Jae ) - 동아대학교 의과대학 내과학교실
김경태 ( Kim Kyoung-Tae ) - 동아대학교 의과대학 내과학교실
백정환 ( Paik Jeung-Hoan ) - 동아대학교 의과대학 내과학교실
정영진 ( Jeong Young-Jin ) - 동아대학교 의과대학 핵의학교실
조광조 ( Cho Kwang-Jo ) - 동아대학교 의과대학 흉부외과학교실
강도영 ( Kang Do-Young ) - 동아대학교 의과대학 핵의학교실
이혁 ( Lee Hyuck ) - 동아대학교 의과대학 내과학교실

Abstract


Prosthetic vascular graft infection (PVGI) is a relatively uncommon complication of peripheral vascular surgery and although rare, is the most severe complication in reconstructive vascular surgery. The early diagnosis of this complication can reduce the mortality. We report a case of aorto-femoral bypass graft infection, which was diagnosed by Tc-99m HMPAO WBC scan, complicated with infective endocarditis. A 60-year-old man had been operated with aortofemoral bypass graft because of aortojejunal fistula due to abdominal aortic aneurysm. Nine months later, he was admitted with fever of two months’ duration. On echocardiolography, aortic regurgitation and vegetation were observed, and then he was diagosed with infective endocarditis. He was treated with antibiotics for 6 weeks. Recurrent bacteremia of unknown origin persisted despite antibiotic therapy. Multiple microorganisms were separately isolated from the blood cultures. He complained of intermittent right groin pain. Imaging study (CT, MRI, US) showed no definite evidence of graft infection. However, Tc-99m HMPAO WBC scan demonstrated uptake in the aortofemoral bypass graft site. The patient underwent emergent aortofemoral graft removal with axillobifemoral bypass and right femoropopliteal bypass.

키워드

Prosthetic graft infection;Infective Endocarditis;Tc-99m HMPAO WBC scan

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