Ramírez CB, Sedó MG, Hütt CE

Language: Spanish
References: 13
Page: 26-34
PDF size: 888.28 Kb.

ABSTRACT

Infective endocarditis is a disease with an elevated morbimortality. It affects mainly patients with degenerative cardiopathy, elderly patients and patients who have suffered rheumatic fever. The valvular and endocardic endothelium is naturally resistant to the colonization of bacteria, hence there has to be an injury and formation of a thrombus that is later colonized by microorganisms, this generates what is known as vegetation. The two main groups of bacteria isolated from bloodcultures are oral Streptococcus and Staphylococcus. The majority of patients present themselves with fever, constitutional symptoms and a new murmur or a murmur that has changed of characteristics. The modified Duke criteria include clinical, microbiological and echocardiographic criteria. It’s advised to perform initially a transthoracic echocardiogram to all patients with a moderate probability to have infective endocarditis. The cardiac complications are the most common, followed by neurologic complications. The new tendency is for patients to be treated with surgery at early stages of the disease, even though, up to 25% of patients with surgical indications arenot operated. The cornerstone of the treatment is parental antibiotic, usually therapy is dual and the two agents used have synergetic properties.

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