{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2022,9,9]],"date-time":"2022-09-09T15:25:44Z","timestamp":1662737144728},"reference-count":12,"publisher":"Georg Thieme Verlag KG","issue":"16","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dtsch Med Wochenschr"],"published-print":{"date-parts":[[2022,8]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:p>\n          Anamnese und klinischer Befund\u2002Station\u00e4re Vorstellung eines 19-j\u00e4higen Patienten mit akutem Schub einer Colitis ulcerosa seit ungef\u00e4hr 6 Wochen und Beschwerdeprogredienz seit anderthalb Wochen. Es bestand eine Therapie mit topischen und oralen 5-Aminosalicyls\u00e4ure-(5-ASA)-Pr\u00e4paraten sowie eine orale Prednisolon-Gabe. Unter Intensivierung der Prednisolondosis Gabe eines monoklonalen Antik\u00f6rpers (Vedolizumab) sowie antibiotische Therapie; station\u00e4re Entlassung gegen \u00e4rztlichen Rat. Bei weiterhin erh\u00f6hten Infektparametern orale Gabe von Ciprofloxacin. Die 5-ASA-Gabe wurde fortgef\u00fchrt. In den folgenden 2 Wochen rezidivierende Fiebersch\u00fcbe und erneute station\u00e4re Aufnahme.<\/jats:p><jats:p>\n          Untersuchungen und Diagnose\u2002Mikrobiologischer Nachweis von Acinetobacter ursingii in den Blutkulturen. Echokardiografischer Nachweis eines Perikard-Ergusses. Die trans\u00f6sophageale Echokardiografie ergab keinen Hinweis auf eine infekti\u00f6se Endokarditis. Serologischer Nachweis erh\u00f6hter Herz-Enzymwerte. Eine MRT-Untersuchung des Herzens best\u00e4tigte die Diagnose einer Perimyokarditis.<\/jats:p><jats:p>\n          Therapie und Verlauf\u2002Intensivmedizinische Betreuung und Resistogramm-gerechte antibiotische Therapie mit Meropenem unter Beendigung der topischen und oralen 5-ASA-Gaben sowie Verzicht auf eine Fortf\u00fchrung der Integrin-Antagonisten-Therapie. Zudem Start einer leitliniengerechten Herzinsuffizienztherapie und Therapieumstellung auf einen Tumor-Nekrose-Faktor-alpha-Blocker. Unter dem akzelerierten Applikationsschema protrahierte Stabilisierung und Besserung des Allgemeinzustandes. Nach 2 Monaten Krankenhausaufenthalt Entlassung des Patienten in die ambulante Versorgung.<\/jats:p><jats:p>\n          Diskussion\u2002Nach l\u00e4ngerfristiger 5-ASA-Gabe ist das Auftreten einer Perimyokarditis m\u00f6glich. Auch der Integrin-Antagonist als neue Therapie kommt urs\u00e4chlich in Frage. Das therapeutische Management bei unklarer Beschwerdeursache richtet sich nach den Beschwerden und der wahrscheinlichsten Krankheitsursache. Bei Nichtansprechen der Therapie fr\u00fchzeitige Re-Evaluationen durchf\u00fchren.<\/jats:p>","DOI":"10.1055\/a-1894-4615","type":"journal-article","created":{"date-parts":[[2022,8,15]],"date-time":"2022-08-15T22:52:02Z","timestamp":1660603922000},"page":"1055-1060","source":"Crossref","is-referenced-by-count":1,"title":["Perimyokarditis als Komplikation einer medikament\u00f6sen Mehrfachtherapie bei Colitis ulcerosa"],"prefix":"10.1055","volume":"147","author":[{"given":"Marcus","family":"Bauer","sequence":"additional","affiliation":[{"name":"Medizinische Klinik II, St. Vincenz-Krankenhaus Datteln, Datteln, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Loant","family":"Baholli","sequence":"additional","affiliation":[{"name":"Medizinische Klinik II, St. Vincenz-Krankenhaus Datteln, Datteln, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lutz","family":"Uflacker","sequence":"additional","affiliation":[{"name":"Medizinische Klinik I, St. Vincenz-Krankenhaus Datteln, Datteln, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sven","family":"Rolffs","sequence":"additional","affiliation":[{"name":"Medizinische Klinik I, St. Vincenz-Krankenhaus Datteln, Datteln, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2022,8,15]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1055\/a-1296-3444","article-title":"Aktualisierte S3-Leitlinie Colitis ulcerosa \u2013 Living Guideline","volume":"58","author":"T Kucharzik","year":"2020","journal-title":"Z Gastroenterol"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"649","DOI":"10.1093\/ecco-jcc\/jjx008","article-title":"Third European Evidence-based Consensus on Diagnosis and Management of Ulcerative Colitis. 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