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感染性心内膜炎领域的变化与进展。

Changes and advances in the field of infective endocarditis.

机构信息

Department of Infection, Immunity and Cardiovascular Disease, The University of Sheffield, Sheffield, UK.

Department of Cardiology, Northern General Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.

出版信息

Br J Hosp Med (Lond). 2022 Mar 2;83(3):1-11. doi: 10.12968/hmed.2021.0510. Epub 2022 Mar 17.

Abstract

Infective endocarditis is a rare but deadly disease, with a highly variable presentation. The clinical manifestations of the condition are often multisystemic, ranging from dermatological to ophthalmic, and cardiovascular to renal. Thus, patients with infective endocarditis may first present to the acute or general physician, who may have a variable knowledge of the condition. The diagnosis of infective endocarditis can be challenging, relying on clinical, imaging and microbiological features. Recent decades have seen a transformation in the epidemiology and microbiology of infective endocarditis and yet, despite advances in diagnostics and therapeutics, mortality rates remain high. This review outlines the emerging studies and guidelines on the assessment and management of infective endocarditis, focusing on the evolving epidemiology of the condition, the role of new imaging modalities, updated diagnostic criteria, the latest on antimicrobial and surgical management, and the role of a multidisciplinary approach in the management of patients with infective endocarditis.

摘要

感染性心内膜炎是一种罕见但致命的疾病,临床表现多样。该病的临床表现常为多系统,包括皮肤、眼科、心血管和肾脏。因此,感染性心内膜炎患者可能首先就诊于急性或全科医生,而后者对该病的认识可能存在差异。感染性心内膜炎的诊断具有挑战性,依赖于临床、影像学和微生物学特征。近几十年来,感染性心内膜炎的流行病学和微生物学发生了变化,但尽管诊断和治疗有所进展,死亡率仍然很高。本综述概述了感染性心内膜炎评估和管理方面的新研究和指南,重点介绍了该病不断变化的流行病学、新影像学方法的作用、更新的诊断标准、最新的抗菌和手术治疗以及多学科方法在感染性心内膜炎患者管理中的作用。

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