Norenberg R G, Sethi G K, Scott S M, Takaro T
Ann Thorac Surg. 1975 May;19(5):592-604. doi: 10.1016/s0003-4975(10)64440-2.
The incidence of endocarditis following open-heart operations is declining, but the relative incidence of endocarditis by the opportunistic organisms, both bacterial and fungal, has increased. These "opportunists" require careful identification and sensitivity testing so that appropriate therapy can be planned. In cases of candida endocarditis, a positive precipitin test and elevated candida antibody titer may provide an earlier means of diagnosis than blood cultures. These patients should be treated promptly with adequate dosages of specific antimicrobial or antifungal agents. Reoperation should be considered early if there is evidence of valve dehiscence or embolic phenomena or if drug therapy fails to control the infection.
心脏直视手术后心内膜炎的发病率正在下降，但由机会性微生物（包括细菌和真菌）引起的心内膜炎的相对发病率有所上升。这些“机会致病菌”需要仔细鉴定和进行药敏试验，以便制定合适的治疗方案。在念珠菌性心内膜炎病例中，沉淀素试验阳性和念珠菌抗体滴度升高可能比血培养提供更早的诊断方法。这些患者应及时用足够剂量的特异性抗菌或抗真菌药物治疗。如果有瓣膜裂开或栓塞现象的证据，或者药物治疗未能控制感染，应尽早考虑再次手术。
