This reference resource represents the consensus opinion a team of international specialists on the diagnosis and treatment of infective endocarditis (IE), many of whom have been co-authors of American or European guidelines on the topic. It is therefore a useful tool for many practitioners: cardiologists and cardiac imagers, cardiac surgeons, echocardiographers, specialists of internal medicine, neurologists, and infectiologists. Infective endocarditis (IE) is defined as an infection of the endocardial surface of the heart, which may include one or more heart valves, the mural endocardium, or a septal defect. Its intracardiac effects include severe valvular insufficiency, which may lead to intractable congestive heart failure and myocardial abscesses. If left untreated, IE is generally fatal. IE is a changing disease with new diagnostic techniques, new therapeutic strategies, more frequent elderly people and patients with prosthetic valves of intravenous drug users.
Endocarditis remains an elusive challenge for clinicians to master. As the population ages and their comorbidities increase, the risk of infecting cardiac structures - both native and, the ever-increasing use of, prosthetic support technology - also increases. In addition, the global epidemic of intravenous substance abuse has also resulted in a substantial increase in the number of infected patients. Fortunately, advances in the diagnostic testing, imaging, and recognition of the importance of a multidisciplinary management team have also contributed to advances in the care of these critically ill patients. Nevertheless, optimal therapies need to be individualized and considered in the ever-increasing body of scientific literature on this complex and difficult problem.
The first up-to-date source on the subject in more than a decade, this authoritative and all-encompassing guide summarizes the latest findings on the epidemiology, pathogenesis, pathophysiology, clinical manifestations, diagnosis, and treatment of infective endocarditis. Written by a world recognized expert with more than 35 years of experience in
|Release Date||: 2015|
|Pages||: 329 pages|
Background and Purpose: Providers vary in their thresholds for obtaining blood cultures in patients with ischemic stroke or transient ischemic attack (TIA). We assessed the rate of missed diagnoses of infective endocarditis (IE) in patients discharged with stroke or TIA before blood culture results could have been available. Methods: Using administrative claims data, we performed a retrospective cohort study of all patients discharged from nonfederal California emergency departments or acute care hospitals from 2005 through 2011 with stroke ( International Classification of Diseases, Ninth Revision, Clinical Modification [ ICD-9-CM ] codes 433.x1, 434.x1, or 436 in any position) or TIA ( ICD-9-CM code 435 in the primary diagnosis position). We excluded patients with a length of stay >2 days to focus on those discharged before conclusive blood culture results could have been available. Our outcome was hospitalization within 14 days with a new diagnosis of IE ( ICD-9-CM codes 391.1 or 421.x in any position). Results: Among 173 966 eligible patients, 24 were subsequently hospitalized for IE—a readmission rate of 1.4 per 10 000 (95% confidence interval [CI], 0.8-1.9 per 10 000). Multiple logistic regression identified the following potential associations with readmission: prosthetic valve: odds ratio (OR), 15.8 (95% CI, 1.9-129.0); other valvular disease: OR, 1.5 (95% CI, 0.2-10.8); urinary tract infection: OR, 3.5 (95% CI, 1.0-12.3; P = .05). Conclusions: In patients with acute cerebral ischemia discharged before blood culture results could have been available, the rate of subsequent IE was negligible. These findings argue against the liberal use of blood cultures for the routine evaluation of stroke or TIA.
Endocarditis is an inflammation of the lining of the heart and valves. It can be due to a non-infectious cause but when the inflammation is associated with an infection, usually bacterial, it is known as infective endocarditis. It is typically characterized by the development of a large septic thrombus on one of the cardiac valves. As this thrombus grows, it can lead to valve failure or may fragment forming a septic embolus that is associated with high mortality if the target of the embolus is the brain, heart or lung. This book reviews multi-organ complications associated with Infective endocarditis including significant recent advances in molecular mechanisms underlying thrombus formation on the cardiac valve, anti-microbial treatment and surgery.
Infective Endocarditis: A Multidisciplinary Approach provides a comprehensive review of infective endocarditis and covers the entire spectrum of medical care for these challenging patients. It covers the ever-increasing scope of the problem, including epidemiology, as well as diagnostic work-up, microbiology, medical therapy, and surgical therapy for this disease. The book also addresses the opioid epidemic and rising infective endocarditis incidence in this population. Each type of practitioner can use this book as a definitive resource in reviewing aspects of care related to the endocarditis patient. The book also serves as an updated resource to provide recent evidence regarding management of these patients, as well as author perspectives and approaches to tackling the often complex and challenging issues revolving around care of the endocarditis patient. This is an essential reference and an authoritative source for infective endocarditis and provide physicians, nurses, social workers, and everyone who is routinely involved in the care of these patients an invaluable resource. Provides a thorough yet concise review from a multidisciplinary perspective on the work-up and management of infective endocarditis Provides an updated review of the evidence and current guidelines for treating patients with infective endocarditis Provides discussion on controversial aspects of management, both medical and ethical
Only current atlas on the topic of infective endocarditis Extensive treatment and diagnostic algorithms in the form of tables and appendices Many never before seen images of high quality
This new addition will provide an update on the current prophylaxis guidelines, the new diagnostic approach in the detection of the disease, the proposed schemas to predict prognosis, and the new treatment strategies to improve the outcome of patients afflicted with this serious condition. Endocarditis is a serious disease with a high rate of morbidity and mortality. The in-hospital mortality remains at 10-20%. The poor outcome of patients with this condition is due in large part to the delay in making the diagnosis which frequently can be elusive. As a result of its wide spectrum of manifestations, endocarditis can mimic many different conditions ranging from stroke to renal failure. In order to minimize the delay in diagnosis, clinicians need to always be mindful of the possibility that endocarditis may be the cause of the symptoms. There have been ongoing efforts in the development of molecular probes and new imaging techniques to improve our ability to identify the disease early and reliably. New treatment strategies have been studied with the aim to prevent complications and to improve survival. The structure of the previous edition is preserved. The book is divided into three sections with the first section covering the historical perspective and basic principles, the second section dealing with the diagnosis and management approaches and the last section on specific clinical situations that pose management dilemmas. All the chapters will be updated to include new information from the recent studies. In particular, the approach to the use of antibiotic prophylaxis will be extensively revised to present and discuss the implications of the current guidelines from different national societies including the American Heart Association and the British Society for Antimicrobial Chemotherapy. This update is timely and should be of interest to all clinicians involved in the care of patients with this serious disease. This new edition will be a good resource for internists, infectious disease specialists, cardiologists and cardiac surgeons alike .