Yang Elaine, Frazee Bradley W
Alameda Health System, 1411 East 31st Street, Highland Hospital, Oakland, CA 94602, USA.
Alameda Health System, 1411 East 31st Street, Highland Hospital, Oakland, CA 94602, USA.
Emerg Med Clin North Am. 2018 Nov;36(4):645-663. doi: 10.1016/j.emc.2018.06.002.
Infective endocarditis (IE) is an uncommon infection of cardiac valves associated with bacteremia. It increasingly affects elderly patients with chronic disease and artificial cardiac devices. The presentation, however, remains subtle and varied, with nonspecific symptoms ranging from those resembling a mild viral infection to septic shock and multiorgan failure. IE carries potential to cause significant morbidity and mortality through its impact on cardiac function and from embolic complications. Blood cultures prior to antibiotics and obtaining prompt echocardiography are key diagnostic steps, followed by proper selection of empiric antibiotics and, in many cases, collaboration with infectious disease, cardiology, and cardiothoracic surgery specialists.
感染性心内膜炎(IE)是一种与菌血症相关的心脏瓣膜罕见感染。它越来越多地影响患有慢性疾病的老年患者和使用人工心脏装置的患者。然而,其表现仍然隐匿且多样,非特异性症状范围从类似轻度病毒感染的症状到感染性休克和多器官功能衰竭。IE通过对心脏功能的影响以及栓塞并发症,有导致严重发病和死亡的可能性。在使用抗生素前进行血培养并及时进行超声心动图检查是关键的诊断步骤,随后要正确选择经验性抗生素,并且在许多情况下,要与传染病、心脏病学和心胸外科专家合作。