Pierard L A, Lancellotti P, Galiuto L
Service de Cardiologie, CHU Sart Tilman, Liege, Belgium.
Eur J Emerg Med. 1994 Jun;1(2):104-9.
Infective endocarditis remains an important problem and the means of prevention are still insufficient. The causal bacteria have changed very little, but the incidence of nosocomial infections and endocarditis complicating intravenous drug abuse are increasing. The distinction between subacute and acute clinical presentations remains appropriate. Cardiac and neurological complications are frequent and carry a high risk of mortality. The diagnosis is obtained by the integration of clinical data and the results of blood cultures. Echocardiography is extremely useful for detecting vegetations, and for assessing the haemodynamic consequences and specific cardiac complications. Risk stratification can be obtained by correct integration of multiple parameters. The causal agent should be identified before the initiation of antimicrobial therapy. Surgery is frequently required, and should be performed rapidly when indicated.
感染性心内膜炎仍然是一个重要问题，预防手段仍不充分。致病细菌变化不大，但医院感染以及静脉药物滥用并发心内膜炎的发生率正在上升。亚急性和急性临床表现之间的区别仍然适用。心脏和神经并发症很常见，且死亡率很高。通过整合临床数据和血培养结果来做出诊断。超声心动图对于检测赘生物、评估血流动力学后果和特定心脏并发症极为有用。通过正确整合多个参数可进行风险分层。在开始抗菌治疗之前应确定病原体。经常需要进行手术，如有指征应迅速进行。
