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endocarditis guidelines

Sven Haller, Meike W Vernooij, Joost P A Kuijer, Elna-Marie Larsson, Hans Rolf Jäger, Frederik Barkhof
Cerebral microbleeds (CMBs), also referred to as microhemorrhages, appear on magnetic resonance (MR) images as hypointense foci notably at T2*-weighted or susceptibility-weighted (SW) imaging. CMBs are detected with increasing frequency because of the more widespread use of high magnetic field strength and of newer dedicated MR imaging techniques such as three-dimensional gradient-echo T2*-weighted and SW imaging. The imaging appearance of CMBs is mainly because of changes in local magnetic susceptibility and reflects the pathologic iron accumulation, most often in perivascular macrophages, because of vasculopathy...
April 2018: Radiology
V Hoerr, M Franz, M W Pletz, M Diab, S Niemann, C Faber, T Doenst, P C Schulze, S Deinhardt-Emmer, B Löffler
Infective endocarditis (IE) is a life-threatening disease, caused by septic vegetations and inflammatory foci on the surface of the endothelium and the valves. Due to its complex and often indecisive presentation the mortality rate is still about 30%. Most frequently bacterial microorganisms entering the bloodstream are the underlying origin of the intracardiac infection. While the disease was primarily restricted to younger patients suffering from rheumatic heart streptococci infections, new at risk categories for Staphylococcus (S...
February 21, 2018: International Journal of Medical Microbiology: IJMM
Slavisa Ninkovic, Zoe McQuilten, Robert Gotmaker, Andrew E Newcomb, Merrole F Cole-Sinclair
BACKGROUND: Transfusion of platelets is common in cardiac surgery, and while there are guidelines for their use, there are concerns about potential risks. We aimed to assess the impact of platelet transfusion on mortality, thrombosis, and infection in this patient group. STUDY DESIGN AND METHODS: A retrospective cohort study of all patients at St Vincent's Hospital Melbourne who underwent a first cardiac surgery procedure from June 2001 to June 2014 was conducted...
March 7, 2018: Transfusion
S Aguadé Bruix, A Roque Pérez, H Cuéllar Calabria, M N Pizzi
Infective endocarditis (IE) is a serious pathology with a poor prognosis, whose mortality has not changed significantly despite advances in its diagnosis and treatment in the last 30years. The diagnostic capacity of the modified Duke criteria in prosthetic endocarditis and/or devices does not exceed 50%, so new tools are necessary for the diagnosis of this entity in this context. The18 F-FDG PET/CTA combines a highly sensitive technique to detect inflammatory-infectious activity and a technique with high anatomical resolution to assess the structural lesions associated with endocarditis...
February 26, 2018: Revista Española de Medicina Nuclear e Imagen Molecular
Khadija Mzoughi, Ihsen Zairi, Samia Ben Hamida, Sofien Kamoun, Fethia Ben Moussa, Sana Fennira, Sondos Kraiem
INTRODUCTION: Infectious endocarditis (IE) is a rare disease with a high mortality. In 2009, the European society of cardiology restricted antibiotic prophylaxis to a smaller number of cardiac conditions with very high risk for IE. Did these changes in the guidelines have an impact on the epidemiological and bacteriological profile of IE? AIM: The main aim of our work was to study the evolution of the microbiological profile of IE from 1991 to 2016. METHODS: We realized an analytic retrospective study comparing two groups: group 1 included patients admitted for a certain IE before September 2009 and group 2 those admitted after that date...
April 2017: La Tunisie Médicale
Yu-Ning Hu, Song Wan
Infective endocarditis (IE) is associated with high mortality and morbidity and requires surgical intervention in about half of all patients. Mitral valve repair (MVrep) is reported to achieve better results than mitral valve replacement because the insertion of a prosthesis during active infection is avoided. However, MVrep in active IE is complicated and no definitive guidelines have been compiled. The current study reviews the literature from 2000 to 2016 and summarizes the surgical details of MVrep for IE...
February 21, 2018: Surgery Today
Juan M Pericàs, Carlos Cervera, Asunción Moreno, Cristina Garcia-de-la-Mària, Manel Almela, Carles Falces, Eduard Quintana, Bàrbara Vidal, Jaume Llopis, David Fuster, Carlos A Mestres, Francesc Marco, Jose M Miró
BACKGROUND: International guidelines recommend 4 weeks of treatment with ampicillin plus gentamicin (A+G) for uncomplicated native valve Enterococcus faecalis infective endocarditis (EFIE) and 6 weeks in the remaining cases. Ampicillin plus ceftriaxone (A+C) is always recommended for at least 6w, with no available studies assessing its suitability for 4w. We aimed to investigate differences in the outcome of EFIE according to the duration (4 versus 6 weeks) of antibiotic treatment (A+G or A+C)...
2018: PloS One
Divyanshu Mohananey, Ashley Mohadjer, Gosta Pettersson, Jose Navia, Steven Gordon, Nabin Shrestha, Richard A Grimm, L Leonardo Rodriguez, Brian P Griffin, Milind Y Desai
Importance: Infective endocarditis is a life-threating condition with annual mortality of as much as 40% and is associated with embolic events in as many as 80% of cases. These embolic events have notable prognostic implications and have been linked to increased length of stay in intensive care units and mortality. A vegetation size greater than 10 mm has often been suggested as an optimal cutoff to estimate the risk of embolism, but the evidence is based largely on small observational studies...
February 19, 2018: JAMA Internal Medicine
Nana Toyoda, Shinobu Itagaki, Henry Tannous, Natalia N Egorova, Joanna Chikwe
BACKGROUND: Consensus guidelines for prosthesis selection in infective endocarditis recommend bioprosthetic or mechanical valve replacement based on life expectancy and comorbidity. However, contemporary outcome data are limited to institution series. METHODS: The outcomes of 3,447 patients identified from mandatory discharge databases in California and New York states who had either primary isolated mitral (n=1603) or aortic (n=1,844) valve replacement for active endocarditis between 1998 and 2010, were compared according to whether they received bioprosthetic (n=1,673, 48...
February 13, 2018: Annals of Thoracic Surgery
Jason R Sims, Nandan S Anavekar, Krishnaswamy Chandrasekaran, James M Steckelberg, Walter R Wilson, Bernard J Gersh, Larry M Baddour, Daniel C DeSimone
Transesophageal echocardiography (TEE) is the gold standard imaging study used in the diagnosis of infective endocarditis (IE). Computed tomography angiography (CTA) has undergone rapid advancement as a cardiac imaging technique and has previously shown promise in small non-randomized studies for evaluation of IE. We hypothesized that cardiac CTA would perform similarly to TEE in the detection of endocarditic lesions and that there would be no difference in clinical outcomes whether the coronary arteries were evaluated by CTA or invasive coronary angiography (ICA)...
February 15, 2018: International Journal of Cardiovascular Imaging
Dominik Wiedemann, Veronika Rupprechter, Julia Mascherbauer, Andreas Kammerlander, Bruno Mora, Kamen Dimitrov, Benedikt Weber, Martin Andreas, Günther Laufer, Alfred Kocher
BACKGROUND: Replacement of the tricuspid valve is uncommon. Prostheses specifically designed for the this position are not available. Bovine, porcine as well as mechanical valve prostheses are currently used, however, the most suitable prosthesis type has not been defined. METHODS: We retrospectively analyzed all consecutive patients who underwent tricuspid valve replacement (TVR) at the Medical University of Vienna from 1996 to 2014. Baseline patient characteristics, prosthesis type, and postoperative outcome data were collected...
February 8, 2018: Journal of Cardiovascular Surgery
Nadish Garg, Mannu Nayyar, Rami N Khouzam, Salem A Salem, Devarshi Ardeshna
The current American Heart Association (AHA)/American College of Cardiology (ACC) guidelines do not recommend antibiotic prophylaxis for infective endocarditis (IE) in patients with acyanotic congenital valvular heart disease due to lack of any proven benefit and potential harm associated with antibiotics. As recognized by the guidelines, some acyanotic congenital heart disease, such as ventricular septal defects (VSDs), are associated with a high velocity jet and pose a greater risk of peri-procedural endocarditis...
January 2018: Annals of Translational Medicine
George S Heriot, Steven Y C Tong, Allen C Cheng, Irani Thevarajan, Michele R Levinson, Kumar Visvanathan, Danny Liew
The objective of this investigation was to assess whether between-hospital variation in echocardiography usage for patients with Staphylococcus aureus bacteraemia (SAB) is explained by differences in patients' pre-test probability of endocarditis. This was a retrospective cohort study at three neighbouring hospitals in Australia. Consecutive episodes of SAB were reviewed for the presence of three endocarditis risk factors (community onset, prolonged bacteraemia and the presence of an intracardiac prosthetic device) and the performance and results of all echocardiography studies within 30 days...
January 22, 2018: European Journal of Clinical Microbiology & Infectious Diseases
Karen Magsino, Rohan Sanjanwala, Brett Hiebert, Janet Rothney, Rizwan Manji, Rakesh Arora, Pallav Shah
BACKGROUND:  The increasing prevalence of intravenous drug users (IVDU) has resulted in higher incidence of right-sided infective endocarditis (RSIE). However, treatment guidelines for RSIE in IVDU are not well defined. The aim is to evaluate efficacy of different treatment strategies in reducing mortality and to describe treatment outcomes. METHODS:  We systematically reviewed the literature using PubMed, Cochrane, CENTRAL, OvidEMBASE, Web of Science, and Medline databases to include prospective studies that compare mortality rates among IVDU with RSIE receiving isolated medical treatment versus those receiving medical-surgical treatment...
January 19, 2018: Thoracic and Cardiovascular Surgeon
Laurens E Swart, Asbjørn M Scholtens, Wilco Tanis, Koen Nieman, Ad J J C Bogers, Fred J Verzijlbergen, Gabriel P Krestin, Jolien W Roos-Hesselink, Ricardo P J Budde
The timely diagnosis of prosthetic heart valve endocarditis remains challenging yet of utmost importance. 18F-fluorodeoxyglucose (18 F-FDG) positron emission/computed tomography (PET/CT) and cardiac computed tomography angiography (CTA) were recently introduced as additional diagnostic tools in the most recent ESC guidelines on infective endocarditis. However, how to interpret PET/CT findings with regard to what is to be considered abnormal, what the potential confounders may be, as well as which patients benefit most from these additional imaging techniques and how to best perform them in these often-complex patients, remains unclear...
January 16, 2018: European Heart Journal
Bruce M Jones, Roby M Hersey, Irwin J Trestman, Christopher M Bland
Advancements in rapid diagnostics have helped to identify nutritionally variant streptococci (NVS) as an increasing cause of infective endocarditis. This case report highlights the challenges in susceptibility testing and the importance of appropriate empiric treatment for Granulicatella adiacens, as well as considerations for future practice guideline recommendations. Guidelines for treatment of IE caused by NVS are currently limited to patients with native valve disease. We present a patient with presumed prosthetic valve endocarditis caused by Granulicatella adiacens, with clinically relevant resistance to recommended first-line agents (penicillin and ceftriaxone), who was successfully treated with 8 weeks of intravenous (IV) vancomycin...
January 9, 2018: International Journal of Antimicrobial Agents
Katie J Suda, Heather Henschel, Ursula Patel, Margaret A Fitzpatrick, Charlesnika T Evans
Background: Guidelines for antibiotics prior to dental procedures for patients with specific cardiac conditions and prosthetic joints have changed, reducing indications for antibiotic prophylaxis. In addition to guidelines focused on patient comorbidities, systematic reviews specific to dental extractions and implants support preprocedure antibiotics for all patients. However, data on dentist adherence to these recommendations are scarce. Methods: This was a cross-sectional study of veterans undergoing tooth extractions, dental implants, and periodontal procedures...
January 2018: Open Forum Infectious Diseases
Francesco Bovenzi, Lucia Borelli, Lauro Cortigiani
: Infective endocarditis is the manifestation of the endocardial involvement during a systemic infectious process.The prognosis of this condition is still dismal, and the mortality associated with it remains high despite improvement in antimicrobial treatment. Antibiotic prophylaxis is still recommended only in high-risk cases, that is, procedures at high risk for inducing systemic bacteremia.It is important to provide an educational prophylaxis consisting of sound hygienic recommendations for the cleansing of the oral cavity, the skin, genital-urinary, and gastrointestinal systems...
January 10, 2018: Journal of Cardiovascular Medicine
Lauge Østergaard, Nana Valeur, Nikolaj Ihlemann, Henning Bundgaard, Gunnar Gislason, Christian Torp-Pedersen, Niels Eske Bruun, Lars Søndergaard, Lars Køber, Emil Loldrup Fosbøl
Aims: Patients with prior infective endocarditis (IE), a prosthetic heart valve, or a cyanotic congenital heart disease (CHD) are considered to be at high risk of IE by guidelines. However, knowledge is sparse on the relative risk of IE between these three groups and compared controls. Methods and results: Using Danish nationwide registries (1996-2015), we identified all patients with prior IE, a prosthetic heart valve, or a complex CHD (defined as tetralogy of Fallot, truncus arteriosus, and transposition of great arteries) as well as matched control populations...
December 12, 2017: European Heart Journal
Andrew Narendran Robinson, Paul Anantharajah Tambyah
Infective endocarditis (IE) is associated with significant morbidity and mortality. The prevention of infective endocarditis, for many years, has involved the identification of at risk patients undergoing medical or dental procedures and the use of pre-procedural antibiotic prophylaxis. However, evidence regarding the effectiveness of such measures is lacking while evidence is mounting for the adverse effects of inappropriate antibiotic use. International guidelines for antibiotic prophylaxis were amended, radically in some cases to reflect this...
December 2017: Singapore Dental Journal
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