Piper Cornelia, Horstkotte Dieter
Kardiologische Klinik, Herz- und Diabeteszentrum Nordrhein-Westfalen, Universitätsklinik der Ruhr-Universität Bochum, Georgstrabe 11, 32545, Bad Oeynhausen.
Med Klin (Munich). 2008 Apr 15;103(4):217-27; quiz 228-9. doi: 10.1007/s00063-008-1031-1.
In patients suffering from infective endocarditis (IE), initial symptoms and clinical findings are unspecific. Physicians primarily involved should always consider IE a potential diagnosis. Any delay in diagnosis and thus in an adequate antimicrobial therapy has a significant negative prognostic influence. Any subject suspected to have IE should immediately have a transthoracic echocardiography (TTE) by an experienced examiner. If the TTE results are inconclusive, transesophageal echocardiography (TEE) has to be performed without delay. Other steps in diagnosis, medical and surgical therapy follow established and evidenced-based guidelines. Antimicrobial regimens are standardized for IE, for which demonstration of causative microorganisms from blood cultures or other microbiological sources is unavoidable. If there are problems in diagnosis, if difficult-to-treat microoganisms are isolated or difficult-to-treat situations complicate active IE, a reference center should be involved.
在患有感染性心内膜炎（IE）的患者中，初始症状和临床发现并无特异性。主要负责的医生应始终将IE视为一种可能的诊断。诊断的任何延迟以及由此导致的适当抗菌治疗的延迟都会对预后产生重大的负面影响。任何疑似患有IE的患者都应立即由经验丰富的检查人员进行经胸超声心动图（TTE）检查。如果TTE结果不明确，则必须立即进行经食管超声心动图（TEE）检查。诊断、药物治疗和手术治疗的其他步骤遵循既定的循证指南。IE的抗菌方案是标准化的，对于IE而言，从血培养或其他微生物学来源中证实致病微生物是不可避免的。如果在诊断方面存在问题，如果分离出难以治疗的微生物或难以治疗的情况使活动性IE复杂化，则应寻求参考中心的帮助。
