Late prosthetic valve endocarditis
| Autor: | Marcus Wiemer, Dieter Horstkotte, R. Niehues, Cornelia Piper, H.-P. Schultheiss |
|---|---|
| Rok vydání: | 1995 |
| Předmět: |
Native Valve Endocarditis
medicine.medical_specialty Prosthesis-Related Infections biology business.industry medicine.drug_class Antibiotics Late Prosthetic Valve Endocarditis Endocarditis Bacterial Prognosis biology.organism_classification medicine.disease Surgery Enterococcus Embolism Viridans streptococci Heart Valve Prosthesis Humans Medicine Endocarditis Cardiology and Cardiovascular Medicine business Complication |
| Zdroj: | European Heart Journal. 16:39-47 |
| ISSN: | 1522-9645 0195-668X |
| DOI: | 10.1093/eurheartj/16.suppl_b.39 |
| Popis: | Prosthetic valve endocarditis remains an extremely serious complication, with a low but increasing incidence. 'Late' endocarditis, occurring more than 60 days after surgery, is relatively infrequently associated with staphylococci, Gram-negative bacteria and fungi so characteristic of the endocarditis that occurs earlier. A probable source of infection can be found in 25%-80% of patients, the most frequent causes being dental procedures, urological infections and interventions, and indwelling catheters. The most common organisms are S. epidermidis, S. aureus, viridans streptococci and enterococci. The general principles of antibiotic treatment are similar to those for native valve endocarditis, but antibiotic treatment needs to be more prolonged and dosages should be used which result in maximal, nontoxic concentrations. Oral anticoagulants should be stopped and replaced by intravenous heparins. Surgical reintervention is called for if there are large highly mobile vegetations in the mitral position or within 72 h if there are cerebral thrombo-embolic episodes. |
| Databáze: | OpenAIRE |
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