Occult bacteraemia in cardiac implantable electronic device patients
| Autor: | Massimo Magnano S Lio, Maria Grazia Bongiorni, Pier Giorgio Golzio |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Pacemaker
Artificial medicine.medical_specialty Prosthesis-Related Infections MEDLINE 030204 cardiovascular system & hematology Workflow 03 medical and health sciences High morbidity 0302 clinical medicine Predictive Value of Tests Risk Factors medicine Humans Endocarditis 030212 general & internal medicine Intensive care medicine Device Removal Radical treatment business.industry Endocarditis Bacterial General Medicine medicine.disease Occult Anti-Bacterial Agents Defibrillators Implantable Heart Rhythm Treatment Outcome Infective endocarditis Predictive value of tests Critical Pathways Cardiology and Cardiovascular Medicine business |
| Zdroj: | Journal of Cardiovascular Medicine. 20:271-277 |
| ISSN: | 1558-2027 |
| DOI: | 10.2459/jcm.0000000000000754 |
| Popis: | Cardiac implantable electronic device (CIED) implantation has greatly increased, with an associated exponential increase in CIED infections (CDIs). Cardiac device related infective endocarditis (CDRIE) has high morbidity and mortality: approximately 10-21%. Therefore, a prompt diagnosis and radical treatment of CDRIE are needed; transvenous lead extraction (TLE) is the mainstay for the complete healing, even if associated with wide logistic problems, high therapeutic costs and high mortality risk for patients. Some criticisms about the value of Duke criteria and their limitations for the diagnosis of CDRIE are known. The significance of classic laboratory data, transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE), considered in the Duke score, are reviewed and critically discussed in this article, with regard to the specific field of the diagnosis of CDI. The need for new techniques for achieving the diagnostic reliability has been well perceived by physicians, and additional techniques have been introduced in the new European Society of Cardiology (ESC) and British Heart Rhythm Society (BHRS) guidelines on infective endocarditis. These suggested techniques, such as 18-Fluorodeoxyglucose PET/computed tomography (FDG-PET/CT), white blood cell PET (WBC PET) and lung multislice CT (MSCT), are also discussed in the study. This short review is intended as an extensive summary of the diagnostic workflow in cases of CDI and will be useful for readers who want to know more about this issue. |
| Databáze: | OpenAIRE |
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