Plicht B, Lind A, Erbel R
Klinik für Kardiologie, Klinikum Westfalen, Am Knappschaftskrankenhaus 1, 44309, Dortmund, Deutschland.
Medizinische Universitätsklinik II, Kardiologie und Angiologie, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil, Bochum, Deutschland.
Internist (Berl). 2016 Jul;57(7):675-90. doi: 10.1007/s00108-016-0086-y.
Infective endocarditis is an endovascular infection usually caused by bacteria. Mortality rate is still approximately 20 %. To improve patients' prognosis by implementation of current diagnostic and therapeutic evidence, the European Society of Cardiology published an updated version of the guidelines for management of infective endocarditis in 2015. It strengthens the role of imaging modalities like PET/CT for detection of infectious foci when echocardiography remains negative and highlights the use of modern tests for identification of possible pathogens. New diagnostic criteria were introduced to integrate these methods for improved diagnostic sensitivity. Complicated cases should be treated in reference centers with on-site cardiac surgery. The antibiotic and early surgical management should be discussed in a multidisciplinary endocarditis team. A few years ago, the indication for endocarditis prophylaxis was limited to high-risk patients. These recommendations were confirmed in current guidelines.
感染性心内膜炎是一种通常由细菌引起的血管内感染。死亡率仍约为20%。为通过实施当前的诊断和治疗证据改善患者预后，欧洲心脏病学会于2015年发布了感染性心内膜炎管理指南的更新版本。当超声心动图检查结果为阴性时，它强化了PET/CT等成像方式在检测感染灶方面的作用，并强调使用现代检测方法来识别可能的病原体。引入了新的诊断标准以整合这些方法，提高诊断敏感性。复杂病例应在具备现场心脏手术条件的参考中心进行治疗。抗生素和早期手术管理应在多学科心内膜炎团队中进行讨论。几年前，心内膜炎预防的指征仅限于高危患者。这些建议在当前指南中得到了确认。
