| Popis: |
62 SUMMARY Despite decreased incidence of rheumatic valvular disease, infective endocarditis remains a severe and deadly disorder. Currently, patients with prosthetic cardiac valves, users of illicit parenteral drugs, hospitalization in which intravenous catheters and other non-rheumatic abnormalities, account for majority of cases of endocarditis. Rheumatic heart diseases is still the most frequent cause of infective endocarditis in developing countries as our result confirm. The number of blood culture negative cases were 7 out 13 (54%). This was due to prior antibiotic therapy. Other potential causes include improper blood cultures techniques, fastidious slow growing organisms, on etiologic agent that is non-culturable such as coxiella burnetii or chlamidya. Duke criteria were used in the diagnosis of infective endocarditis in our study. These were found to be more spesific than the prior diagnostic criteria. The major indication for surgical intervention in our series is cardiac heart failure secondary to valvular dysfunction. The other indications for surgery were multipl cerebral emboli, presence of large vegetations and resistance to medical therapy. Postoperative pathologic results were compared with clinical findings. Sensivity of microbiologic criteria (blood cultures), TTE, TEE were 55%, 92%, 100% respectively. Specifity of them were 100%, 66%, 100% respectively. Duke criteria63 which emphasize typical echocardiography findings and microbiologic results were found to be 83% sensitive, 100% specific for the definitive diagnosis of infective endocarditis. 72 |
