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      Bacterial Endocarditis at a Tertiary Hospital – How Do We Improve Diagnosis and Delay of Treatment?

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          Abstract

          During a period of 3.5 years, endocarditis was suspected in 151 patients admitted to Rigshospitalet. 140 were available for this study. In 59 of the 140 patients, the diagnosis was confirmed, and 36 had positive blood cultures. Echocardiographic findings compatible with the diagnosis were present in 92% of the 59 cases. The most common causes of endocarditis were Staphylococcus aureus and viridans streptococci. Patients with endocarditis caused by S. aureus had significantly (p = 0.002) more embolic episodes compared to patients having endocarditis caused by the viridans streptococci. The diagnosis was established at a mean of 3–4 weeks after the onset of symptoms and 2 weeks after admission to hospital. In order to minimize diagnostic delay, the following aspects may be important: (1) earlier detection of endocarditis among physicians examining patients at risk; (2) educating patients with cardiac disease and cardiac valve prosthesis; (3) earlier antibiotic therapy, and (4) developing further diagnostics for endocarditis.

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          Most cited references 3

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          The complications of infective endocarditis. A reappraisal in the 1980s.

          The frequency of complications of infective endocarditis and their influence on the outcome of the patients changed in the antibiotic era. Therefore, we evaluated the complications in a recent large series of patients with infective endocarditis.
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            Staphylococcus aureus endocarditis. A review of 119 cases.

            Staphylococcus aureus endocarditis cases in Denmark from 1976 to 1981 were reviewed. A total of 119 patients--61 female and 58 male, with a median age of 63 years (range, 1 month to 85 years)--fulfilled the diagnostic criteria. Community-acquired infections were most common (62%), but the frequency of hospital-acquired cases (38%) was greater than in earlier reports. The clinical picture was relatively nonspecific, and 32% of the patients had no heart murmurs initially. In 65 cases (55%), endocarditis was not suspected clinically, and the diagnosis was first obtained at autopsy. The mortality was 71% and correlated with age, hospital-acquired infection, and the presence of heart failure and arterial embolism.
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              Imported and Autochthonous Histoplasmosis in Bergamo Province, Northern Italy

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                Author and article information

                Journal
                CRD
                Cardiology
                10.1159/issn.0008-6312
                Cardiology
                S. Karger AG
                0008-6312
                1421-9751
                1998
                January 1998
                13 February 1998
                : 89
                : 2
                : 79-86
                Affiliations
                Department of Clinical Microbiology and Medical Department B, Division of Cardiology, Rigshospitalet, Copenhagen, Denmark
                Article
                6761 Cardiology 1998;89:79–86
                10.1159/000006761
                9524007
                © 1998 S. Karger AG, Basel

                Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

                Page count
                Figures: 1, Tables: 3, References: 53, Pages: 8
                Categories
                General Cardiology

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