Tìm thấy 20+ kết quả cho từ khóa "Infective Endocarditis"
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Karchmer AW: Infective endocarditis, in Heart Disease, 8th ed, E Braunwald et al (eds). Li JS et al: Proposed modifications to the Duke criteria for the diagnosis of infective endocarditis. Moreillon P, Que YA: Infective endocarditis. Morris AJ et al: Bacteriological outcome after valve surgery for active infective endocarditis: Implications for duration of treatment after surgery (abstract).
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Imaging with echocardiography allows anatomic confirmation of infective endocarditis, sizing of vegetations, detection of intracardiac complications, and assessment of cardiac function (Fig. however, it cannot image vegetations <2 mm in diameter, and in 20% of patients it is technically inadequate because of emphysema or body habitus. Thus, TTE detects vegetations in only 65% of patients with definite clinical endocarditis. TEE is safe and significantly more sensitive than TTE..
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Infective Endocarditis (Part 5). Table 118-3 The Duke Criteria for the Clinical Diagnosis of Infective Endocarditis. Typical microorganism for infective endocarditis from two separate blood cultures
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Infective Endocarditis (Part 3). The clinical syndrome of infective endocarditis is highly variable and spans a continuum between acute and subacute presentations. The causative microorganism is primarily responsible for the temporal course of endocarditis. Endocarditis caused by Staphylococcus lugdunensis (a coagulase-negative species) or by enterococci may present acutely. Subacute endocarditis is typically caused by viridans streptococci, enterococci, CoNS, and the HACEK group..
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Infective Endocarditis (Part 1). Infective Endocarditis. Infective Endocarditis: Introduction. Infection most commonly involves heart valves (either native or prosthetic) but may also occur on the low-pressure side of the ventricular septum at the site of a defect, on the mural endocardium where it is damaged by aberrant jets of blood or foreign bodies, or on intracardiac devices themselves.
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Infective Endocarditis (Part 13). Timing of Cardiac Surgery. In general, when indications for surgical treatment of infective endocarditis are identified, surgery should not be delayed simply to permit additional antibiotic therapy, since this course of action increases the risk of death (Table 118-6). After 14 days of recommended antibiotic therapy, excised valves are culture-negative in 99% and 50% of patients with streptococcal and S.
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To date, serologic assays have not proved useful for the diagnosis of staphylococcal infections. aureus bacteremia also have infective endocarditis or a metastatic focus of infection remains a diagnostic challenge (see "Bacteremia, Sepsis, and Infective Endocarditis,". Postviral pneumonia (e.g., influenza). Metastatic foci of infection (kidney, joints, bone, lung). Infective endocarditis. Infective Endocarditis.
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Epidemiologic evidence suggests that prosthetic valve endocarditis due to CoNS that presents 2–12 months after surgery often represents delayed-onset nosocomial infection. At least 85% of CoNS strains that cause prosthetic valve endocarditis within 12 months of surgery are methicillin-resistant. the rate of methicillin resistance decreases to 25% among CoNS strains causing prosthetic valve endocarditis that presents >1 year after valve surgery..
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Abbreviation: PVE, prosthetic valve endocarditis.
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Corynebacterial endocarditis is treated with penicillin plus an aminoglycoside (if the organism is susceptible to the aminoglycoside) or with. Therapy for Candida endocarditis consists of amphotericin B plus flucytosine and early surgery. long- term (if not indefinite) suppression with an oral azole is advised. Caspofungin treatment of Candida endocarditis has been effective in sporadic cases;. nevertheless, the role of echinocandins in this setting has not been established.. Empirical Therapy.
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To select the optimal therapy for streptococcal endocarditis, the minimum inhibitory concentration (MIC) of penicillin for the causative isolate must be determined (Table 118-4). The 2-week penicillin/gentamicin or ceftriaxone/gentamicin regimens should not be used to treat complicated native valve infection or prosthetic valve endocarditis.
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Although heart murmurs are usually indicative of the predisposing cardiac pathology rather than of endocarditis, valvular damage and ruptured chordae may result in new regurgitant murmurs. In acute endocarditis involving a normal valve, murmurs are heard on presentation in only 30–45% of patients but ultimately are detected in 85%.
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Isolated tricuspid valve endocarditis, even with persistent fever, rarely requires surgery.. Prevention of Systemic Emboli.
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Experts favor echocardiographic evaluation of all patients with a clinical diagnosis of endocarditis. however, the test should not be used to screen patients with a low probability of endocarditis (e.g., patients with unexplained fever). An American Heart Association approach to the use of echocardiography for evaluation of patients with suspected endocarditis is illustrated in Fig.
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In this setting, surgical treatment improves outcome, with mortality rates of 20% in native valve endocarditis and 35–55% in prosthetic valve infection. aureus prosthetic valve endocarditis exceed 70% with medical treatment but are reduced to 25% with surgical treatment. aureus prosthetic valve infection, surgical treatment reduces the mortality rate twentyfold. Surgical treatment should be considered for patients with S
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The overall incidence of S. aureus endocarditis has increased over the past 20 years. aureus is now the leading cause of endocarditis worldwide, accounting for 25–35% of cases. This increase is due, at least in part, to the increased use of intravascular devices. transesophageal echocardiography (TEE) studies found an infective endocarditis incidence of 25% among patients with S.. aureus bacteremia and intravascular catheters.
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Ing MB et al: Bacteremia and infective endocarditis: Pathogenesis, diagnosis, and complications, in The Staphylococci in Human Disease, KB Crossley, GL Archer (eds). von Eiff C et al: Pathogenesis of infections due to coagulase-negative staphylococci
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Osteomyelitis, especially where prosthetic devices have been implanted, and infective endocarditis must be considered. Although true culture-negative infective endocarditis is rare, one may be misled by slow-growing organisms of the. (previously Rochalimaea), Legionella spp., Coxiella burnetii, Chlamydophila psittaci, and fungi. Prostatitis, dental abscesses, sinusitis, and cholangitis continue to be sources of occult fever..
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Paturel L et al: Actinobacillus actinomycetemcomitans endocarditis. Shie SS et al: Characteristics of Achromobacter xylosoxidans bacteremia in northern Taiwan. Udaka T et al: Eikenella corrodens in head and neck infections. Darras-Joly C et al: Haemophilus endocarditis: Report of 42 cases in adults and review. Clin Infect Dis PMID: 9195062]. Das M et al: Infective endocarditis caused by HACEK microorganisms..
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Maayan H et al: Infective endocarditis due to Moraxella lacunata: Report of 4 patients and review of published cases of Moraxella endocarditis. Scand J Infect Dis . Murphy TF et al: Moraxella catarrhalis in chronic obstructive pulmonary disease: Burden of disease and immune response. Am J Respir Crit Care Med PMID: 15805178]. Sethi S et al: New strains of bacteria and exacerbations of chronic obstructive pulmonary disease. N Engl J Med PMID: 12181400].