Matthews D
University of Maryland.
Nurse Pract. 1994 Aug;19(8):53-60. doi: 10.1097/00006205-199408000-00015.
Infective endocarditis, a microbial infection of the endocardium, is a complex multifaceted disease that may affect any organ system. Despite advances in diagnostic technology and treatment, overall mortality rates from infective endocarditis remain between 15-45%, and as high as 40-70% among the elderly. Explanations for the persistence of high mortality rates have focused on delays or errors in diagnosis. The classic diagnostic triad of fever, cardiac murmur, and positive blood cultures are not always present. Elderly patients often have more non-specific symptoms than do younger patients. Infective endocarditis should be considered in conditions dominated by the insidious onset of congestive heart failure, acute mental status or neurological changes, or the acute onset of arthralgias or myalgias. This article reviews the pathogenesis, epidemiology and etiology, risk factors, and clinical presentations of infective endocarditis, as well as current recommendations for antibiotic prophylaxis.
感染性心内膜炎是一种心内膜的微生物感染，是一种复杂的多方面疾病，可能影响任何器官系统。尽管诊断技术和治疗取得了进展，但感染性心内膜炎的总体死亡率仍在15%至45%之间，在老年人中高达40%至70%。高死亡率持续存在的原因主要集中在诊断延迟或错误。发热、心脏杂音和血培养阳性这一经典诊断三联征并不总是出现。老年患者往往比年轻患者有更多非特异性症状。在以隐匿性充血性心力衰竭、急性精神状态或神经变化、或关节痛或肌痛急性发作为主的情况下，应考虑感染性心内膜炎。本文综述了感染性心内膜炎的发病机制、流行病学和病因、危险因素、临床表现，以及目前抗生素预防的建议。
