RESUMEN
Modern approaches to diagnostics of infective endocarditis (IE) are considered in the article. Possibilities for detection of the disease provided by various diagnostic criteria are analyzed. The authors demonstrate the advantages of improved criteria and present the diagnostic signs of subacute endocarditis in congenital heart diseases, artificial valve IE, and IE in drug addicts. Differential diagnostics issues are covered as well.
Asunto(s)
Endocarditis Bacteriana/diagnóstico , Endocarditis Bacteriana/microbiología , Diagnóstico Diferencial , Electrocardiografía , Endocarditis Bacteriana/sangre , Auscultación Cardíaca , HumanosRESUMEN
The purpose of the study was to determine peculiarities of the clinico-morphological picture of modern infective endocarditis (IE). The authors generalize the results of 100 morphological studies of acute and subacute IE (AIE and SAIE) within the last 20 years (1985--2005). AIE and SAIE had developed in 52% and 35% of cases, respectively, after operations, medical manipulations and examinations. The development of secondary AIE was favored by congenital heart defects and mitral valvular (MV) prolapse, while secondary SAIE developed in patients with congenital heart defects as well as atherosclerotic and rheumatic heart defects. The feature of contemporary IE is the prevalence of primary clinico-morphological form with isolated aortal valvular (A V) lesion. Morphological changes in organs formed as a result of multiple septic embolism, immunocomplex lesion, panarteritis, and cardiac insufficiency. The occurrence and progress of the latter was caused by prominent AV and MV insufficiency (during several weeks in patients with AIE and several months in SAIE), myocarditis, pericarditis, myocardial dystrophy, and cardiosclerosis.
Asunto(s)
Endocarditis Bacteriana/microbiología , Endocarditis Bacteriana/fisiopatología , Enfermedad Aguda , Adulto , Candidiasis/complicaciones , Endocarditis Bacteriana/epidemiología , Femenino , Humanos , Hidrotórax/epidemiología , Masculino , Infecciones Estafilocócicas/complicacionesAsunto(s)
Personal Militar , Neumonía Bacteriana/diagnóstico , Neumonía Bacteriana/tratamiento farmacológico , Adulto , Infecciones Comunitarias Adquiridas/complicaciones , Infecciones Comunitarias Adquiridas/diagnóstico , Infecciones Comunitarias Adquiridas/tratamiento farmacológico , Humanos , Masculino , Neumonía Bacteriana/complicaciones , Federación de RusiaRESUMEN
The purpose of the study was to develop and perfect complex therapy of modern infective endocarditis (IE). Ten-year experience in clinical diagnostics of 240 patients with acute, subacute, and lingering IE was summarized; the effectiveness of their treatment was evaluated. The features of modern IE were acute and subacute course of the disease with the involvement of aortal (37.8% of cases), tricuspid (16.8%), mitral (15.2%) valve, and septicemia, caused by highly virulent microflora (staphylococci--51% of cases; gram-negative bacteria--13%; fungi--5%). The clinical manifestations of modern IE included toxic infectious syndrome (24% of cases), heart failure (21%), symptoms of complications (16%), central hemodynamics disturbances (12%), and splenomegaly (8%). The treatment included antibacterial, pathogenetic, and symptomatic therapy, as well as extracorporal hemocorrection and cardiosurgery. Analysis of the results of surgical treatment of 140 IE patients allowed development of indications for valve prosthesis.
Asunto(s)
Antibacterianos/uso terapéutico , Cefalosporinas/uso terapéutico , Endocarditis Bacteriana/tratamiento farmacológico , Endocarditis Bacteriana/cirugía , Adulto , Terapia Combinada , Endocarditis Bacteriana/mortalidad , Femenino , Humanos , Masculino , Tasa de SupervivenciaRESUMEN
The article considers the peculiarities of the development and clinical course of contemporary infective endocarditis (IE). The prevalence of various infective pathogens causing IE over the last decades is analyzed. Modern concepts of the pathogenesis of the disease are covered. The rate of IE complication is analyzed.