infective endocarditis pages 118 125 pdf

... "Echocardiography," below) Table 118- 1 Organisms Causing Major Clinical Forms of Endocarditis Percent of Cases Native Prostheti Valve Endocarditis c Endocarditis Valve in Injection Drug Endocarditis at Users ... cause sporadic episodes of endocarditis, only a few bacterial species cause the majority of cases (Table 1181 ) The pathogens vary somewhat with the clinical types of endocarditis, in part because ... and health care–associated infection The incidence of endocarditis is notably increased among the elderly In reported series, 10–30% of endocarditis cases involve prosthetic valves The risk of...

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... defibrillator–associated endocarditis is usually nosocomial The majority of episodes occur within weeks of implantation or generator change and are caused by S aureus or CoNS Endocarditis occurring ... Polymicrobial endocarditis is more common among injection drug users than among patients who not inject drugs The presence of HIV in the former population does not significantly influence the causes of endocarditis ... have a more varied etiology and involve abnormal valves, often ones damaged by prior episodes of endocarditis A number of these cases are caused by Pseudomonas aeruginosa and Candida species, and...

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... Endocarditis caused by Bartonella species and the agent of Q fever, C burnetii, is exceptionally indolent Table 118- 2 Clinical and Laboratory Features of Infective Endocarditis Feature ... The clinical features of endocarditis are nonspecific However, these symptoms in a febrile patient with valvular abnormalities or a behavior pattern that predisposes to endocarditis (e.g., injection ... (e.g., injection drug use) suggest the diagnosis, as bacteremia with organisms that frequently cause endocarditis, otherwiseunexplained arterial emboli, and progressive cardiac valvular incompetence...

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... in S aureus endocarditis; surgically drainable intracerebral abscesses are infrequent Figure 118- 2 Septic emboli with hemorrhage and infarction due to acute Staphylococcus aureus endocarditis ... lesions (subungual hemorrhage, Osler's nodes) is common in patients with acute S aureus endocarditis (Fig 118- 2) Musculoskeletal symptoms, including nonspecific inflammatory arthritis and back ... on the left side of the heart presents with the typical clinical features of endocarditis Health care–associated endocarditis (defined as that which is nosocomial, arises after recent hospitalization,...

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... possible infective endocarditis increases the specificity of the schema without significantly reducing its sensitivity Table 118- 3 The Duke Criteria for the Clinical Diagnosis of Infective Endocarditis ... organism consistent with infective endocarditis a Transesophageal echocardiography is recommended for assessing possible prosthetic valve endocarditis or complicated endocarditis b Excluding ... cases of possible infective endocarditis when either one major and one minor criterion or three minor criteria are identified Requiring the identification of clinical features of endocarditis for...

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... allows anatomic confirmation of infective endocarditis, sizing of vegetations, detection of intracardiac complications, and assessment of cardiac function (Fig 118- 3) Transthoracic echocardiography ... patients with definite endocarditis; nevertheless, false-negative studies are noted in 6–18% of endocarditis patients TEE is the optimal method for the diagnosis of prosthetic endocarditis or the ... antimicrobial therapy should not be administered initially to hemodynamically stable patients with subacute endocarditis, especially those who have received antibiotics within the preceding weeks; thus, if...

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... undergo surgery for endocarditis Infective Endocarditis: Treatment Antimicrobial Therapy It is difficult to eradicate bacteria from the avascular vegetation in infective endocarditis because ... of patients with endocarditis The erythrocyte sedimentation rate, C-reactive protein level, and circulating immune complex titer are commonly increased in endocarditis (Table 118- 2) Cardiac catheterization ... should be adhered to unless alterations are required by adverse events Table 118- 4 Antibiotic Treatment for Infective Endocarditis Caused by Common Organismsa Organism Drug (Dose, Duration) Comments...

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... in patients with enterococcal endocarditis who have responded satisfactorily to therapy Staphylococci The regimens used to treat staphylococcal endocarditis (Table 118- 4) are based not on coagulase ... daptomycin] in the treatment of endocarditis has not been established Although the dose of gentamicin used to achieve bactericidal synergy in treating enterococcal endocarditis is smaller than that ... killing; consequently, they should not in general be used to treat enterococcal endocarditis Enterococci causing endocarditis must be tested for high-level resistance to streptomycin and gentamicin,...

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... surgical treatment of endocarditis are not absolute (Table 118- 5) The risks and benefits as well as the timing of surgical treatment must therefore be individualized (Table 118- 6) ... pathogens associated with the specific endocarditis syndrome and the hazards of suboptimal therapy must be considered Thus, empirical therapy for acute endocarditis in an injection drug user ... not the determinants of therapy for subacute endocarditis Pending the availability of diagnostic data, blood culture–negative subacute native valve endocarditis is treated with ceftriaxone plus...

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... days of antimicrobial therapy Fungal endocarditis (mold) Fungal endocarditis (Candida spp.) Antibiotic-resistant organisms Abbreviation: PVE, prosthetic valve endocarditis Source: Adapted from L ... embolism Persistent unexplained fever (≥10 days) in culture-negative native valve endocarditis Poorly responsive or relapsed endocarditis due to highly antibioticresistant enterococci or gram-negative ... are often combined with other indications to prompt surgery Table 118- 6 Timing of Cardiac Surgical Intervention in Patients with Endocarditis Indication for Surgical Intervention Timing Strong...

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... 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) ... and S aureus endocarditis, respectively Recrudescent endocarditis involving a new implanted prosthetic valve follows surgery in 2% of patients with culture-positive native valve endocarditis ... culture–positive or –negative endocarditis) despite optimal antibiotic therapy may reflect uncontrolled infection and may warrant surgery Surgical treatment is also advised for endocarditis caused by...

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... develops in 3–5% of patients with endocarditis Effective therapy requires either image-guided percutaneous drainage or splenectomy Mycotic aneurysms occur in 2–15% of endocarditis patients; half of ... culture–positive or –negative endocarditis) despite optimal antibiotic therapy may reflect uncontrolled infection and may warrant surgery Surgical treatment is also advised for endocarditis caused by ... gram-negative bacilli, Brucella species, and probably C burnetii S aureus Endocarditis Mortality rates for S aureus prosthetic valve endocarditis exceed 70% with medical treatment but are reduced to...

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... develops in 3–5% of patients with endocarditis Effective therapy requires either image-guided percutaneous drainage or splenectomy Mycotic aneurysms occur in 2–15% of endocarditis patients; half of ... rather to the interactions of comorbidities and endocarditis- related end-organ complications Overall survival rates for patients with native valve endocarditis caused by viridans streptococci, ... aureus native valve endocarditis in patients who not inject drugs, survival rates are 55–70%, whereas 85–90% of injection drug users survive this infection Prosthetic valve endocarditis beginning...

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... of infective endocarditis Executive summary, The Task Force on Infective Endocarditis of the European Society of Cardiology Eur Heart J 25:267, 2004 [PMID: 14972429] Karchmer AW: Infective endocarditis, ... modifications to the Duke criteria for the diagnosis of infective endocarditis Clin Infect Dis 30:633, 2000 [PMID: 10770721] Moreillon P, Que YA: Infective endocarditis Lancet 363:139, 2004 [PMID: 14726169] ... published online 4/19/07 Table 118- 8 High-Risk Cardiac Lesions for Which Endocarditis Prophylaxis Is Advised before Dental Procedures Prosthetic heart valves Prior endocarditis Unrepaired cyanotic...

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... for any errors that may have crept in ACTIVE SERVER PAGES 3.0 INTRODUCTION THE NEED FOR ASP SO WHAT IS ASP ? W HAT CAN YOU DO WITH ACTIVE SERVER PAGES? W HAT DO SERVER-SIDE SCRIPTS LOOK LIKE? W ... ACTIVE SERVER PAGES 3.0 About this guide This practical guide was prepared as a reference for the ASP Workshop...

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... after phone I'm phoning the office, NOT I'm phoning to the office 70 Verb + preposition + ing-form 125 EXERCISES Prepositions with look (A) Complete the conversation between Laura and her friend...

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