Clinical, Echocardiographic and Microbiological Evaluation Of Infective Endocarditis In Cardiac Patients Research Article (original) (raw)
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Clinical, Echocardiographic and Microbiological Evaluation Of Infective Endocarditis In Cardiac Patients, 2021
Background: We planned to study cases of Infective endocarditis (IE) to define diagnostic criteria and to arrange treatment protocol. Methods: The study included 1121 patients, divided in to two groups. Group 1 included 57 patients with IE. Those were collected over a period of 37 months. Group 2 included 1064 patients who under went cardiac surgery or intervention. Patients were examined clinically, had ECG, X-ray, Echocardiography, and blood culture. Then they were followed up for six months. Results: The incidence of IE was 15 patients/ 1000 cardiac admissions. The incidence of Prosthetic Valve Endocarditis (PVE) was found to be 1.7% of PV replacement. Group I (57 IE patients). Preexisting heart disease was present in 55 patients (96.5%). The underlying heart diseases were rheumatic in 39 (68.4%). Echocardiography detected vegetations in 86% of patients with NVE, while only 28.6% of PVE. Positive blood culture was found in 72%. 58% lived the follow-up period (33/57). The causes of death were heart failure, pulmonary embolism, and cerebral hemorrhage. There was no correlation between the change in vegetation size and success of therapy. Conclusions: We defined diagnostic criteria of IE and set the antimicrobial protocol of management.
International Scholarly Research Notices, 2014
Infective endocarditis, a great masquerader, is a clinical entity which may present with a myriad of manifestations. Its changing epidemiological profile has been studied in the previous decades in both the developed and the developing nations. In this study, we strived to uphold the evolving clinical profile and its outcome from a government tertiary care hospital in Northern India. It was a descriptive, cross-sectional, observational study conducted over two years’ period involving 44 patients diagnosed with definite infective endocarditis, according to modified Dukes’ criteria. Demographic, clinical, microbiological, and echocardiographic data were analysed. Mean age of patients was 31 years. Rheumatic heart disease with regurgitant lesions was the commonest risk factor. Dyspnea and fever were the predominant symptom, and pallor and heart failure the commonest sign. Cultures were positive in 52% with Staphylococcus, the major isolate. Transesophageal echocardiography fared better...
GMS hygiene and infection control, 2017
Background: Infective endocarditis (IE) is a microbial infection of heart valves and its endothelial lining which is considered as a life-threatening disorder. This study evaluated the epidemiological, clinical, and microbiological features of IE at the Cardiovascular Research Center in Yazd, Iran. Methods: The cross-sectional study was conducted on 20 patients diagnosed with definite IE on the basis of Duke's criteria hospitalized for one year in the Cardiovascular Research Center in Yazd, Iran, from January 2015 to December 2015. Demographic information, clinical, laboratory, and microbiological findings, and also trans-esophageal echocardiography (TEE) of each patient were recorded and assessed. The collected data were analyzed using SPSS 16. Results: The mean age of the patients under study was 45±16 years with most of the afflicted patients (60%) being male. Most cases (70%) of IE were observed in the warm seasons (spring and summer). The most common clinical sign (80%) was...
Current diagnosis and treatment of infective endocarditis
Expert Review of Anti-infective Therapy, 2003
The incidence of infective endocarditis continues to rise with a yearly incidence of around 15,000 to 20,000 new cases in the USA. As a result, rapid diagnosis, effective treatment and prompt recognition of complications are essential to desirable clinical outcomes. Recent guidelines such as the Duke criteria have incorporated echocardiography for diagnosis of infective endocarditis, making this diagnostic test mandatory for patients with suspected infective endocarditis. The diversity of pathogens that can cause infective endocarditis, some of which cannot be cultured easily, makes diagnosis even more difficult. Coagulase-negative staphylococci and viridans streptococci groups continue to be the major causative microorganisms of infective endocarditis. In the case of culture-negative endocarditis or infective endocarditis caused by fastidious microorganisms, the polymerase chain reaction and probe-based diagnostic methods are available to clinical reference laboratories.
Changing trends of infective endocarditis
JPMA. The Journal of the Pakistan Medical Association, 2010
To determine the frequency of culture positive and culture negative endocarditis and type of organisms causing bacterial endocarditis in patients admitted at National Institute of Cardiovascular Diseases (NICVD), Karachi. This was a cross sectional, descriptive study conducted from 29th March 2006 to 13th October 2006 at National Institute of Cardiovascular Diseases, Karachi. All patients having clinical suspicion of infective endocarditis were admitted and worked up. Seventy five patients having definite infective endocarditis as per Duke Criteria were included. There were 55 (70%) males and 20 (30%) females. Mean age of the patients was 23 +/- 8.9 years. Ninety percent of the patients were below 40 years of age. Six patients had prosthetic valve and six were intravenous drug abusers. The commonest signs and symptoms observed were fever, shortness of breath, weight loss, murmur, pallor and splenomegaly. Mitral valve was affected in majority of patients. Blood cultures were positive...
Journal of Epidemiology and Global Health
Background Infective endocarditis (IE) is a serious disease with complex pathology and significant mortality. Little information is known regarding clinical and microbiological characteristics in Saudi Arabia. This study surveyed these characteristics at a Cardiac Center in Riyadh, Saudi Arabia over a period of 5 years. Methods This retrospective study was done on all infective endocarditis (IE) patients admitted to Prince Sultan Cardiac Center between January 1, 2015, and December 31, 2019. Clinical characteristics, microbiological results, management, and outcomes were assessed. Result A total of 340 cases of infective endocarditis were identified over the study period. Most patients (64%) were 50 years old or above, and 67% were males. Fever was the most common clinical presentation, and a murmur was audible in a fifth of patients. Blood cultures were positive in 177 (52%) cases. The most common organisms were Staphylococcus aureus, coagulase negative Staphylococcus and viridans ...
Infective Endocarditis : A Brief Overview
2015
Bacterial endocarditis is a serious infection of the heart valves caused mainly by Staphylococcus aureus and Streptococcusviridans. The objective of this study was to conduct a literature review of the main guidelines for the AHA and work related to bacterial resistance and the applicability of these standards in clinical cases. It was infective endocarditis. Concluded that, although relatively uncommon, is a disease que causes substantial morbidity and mortality. Although the advances in diagnosis and treatment have improved antimicrobial, prevention is still an important factor.
Molecular Diagnosis of Infective Endocarditis: A Helpful Addition to the Duke Criteria
Clinical Medicine & Research, 2004
Infective endocarditis (IE) remains a disease of concern because of its relatively high morbidity and mortality if not treated aggressively. Its incidence rate is between 1.7 to 6.2 cases per 100,000 in the general population and has remained essentially unchanged in the last two decades. 1 Presently, there is a shift in the demographics of populations at risk, with IE being seen more often in intravenous drug users, 2 patients exposed to nosocomial settings, 3 and hemodialysis patients. 4 A number of review articles on IE are available for a detailed discussion of this topic. The current Duke classification criteria are used worldwide and are extremely useful in the diagnosis of native valve IE. These diagnostic guidelines include major and minor criteria, such as positive microbiological cultures, vegetations seen by echocardiography, fever, and the presence or absence of a predisposing heart condition. The Duke criteria have been found to be more sensitive than the von Reyn criteria in identifying IE cases as shown by Andrès et al. 9 in a study of 38 patients in a clinical internal medicine practice. The enhanced sensitivity was due to the incorporation of echocardiographic findings in the Duke criteria. However, the utility of the Duke criteria has not been adequately assessed in patients with proven or suspected prosthetic valve endocarditis (PVE) or in selected populations, such as patients with congenital heart disease, in patients on chronic dialysis, or in hospitalized patients with indwelling catheters and bacteremia. In a study by Ben-Ami et al., 8 the rate of hospital-associated IE was 27 cases per 100,000 persons, suggesting a broadening of the definition of hospital-acquired IE.
Journal of cardiology, 2017
The etiology of infective endocarditis (IE) is changing. More aggressive forms with multiple IE cardiac lesions have become more frequent. This study sought to explore the relationship between contemporary causative microorganisms and IE cardiac lesions and to analyze the impact of multiple lesions on treatment choice. In 246 patients hospitalized for IE between 2008 and 2015, cardiac lesions caused by IE were analyzed by echocardiography, classified according to the 2015 European Society of Cardiology guidelines and correlated with microbiological data. We defined a new parameter, the Echo IE Sum, to summarize all IE cardiac lesions in a single patient, enabling comprehensive comparisons between different etiologies and treatment strategies. Staphylococcus aureus was associated with the development of large vegetation (OR 2.442; 95% CI 1.220-4.889; p=0.012), non-HACEK bacteria with large vegetation (OR 13.662; 95% CI 2.801-66.639; p=0.001), perivalvular abscess or perivalvular pseu...