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      Aspergillus endocarditis in the recent years, report of cases of a multicentric national cohort and literature review

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      Mycoses
      Wiley

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          Abstract

          <p class="first" id="d4138657e288">(1) To describe the incidence, clinical characteristics, treatment and outcome of Aspergillus Endocarditis (AE) in a nationwide multicentric cohort (GAMES). (2) To compare the AE cases of the GAMES cohort, with the AE cases reported in the literature since 2010. (3) To identify variables related to mortality. </p>

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          2015 ESC Guidelines for the management of infective endocarditis: The Task Force for the Management of Infective Endocarditis of the European Society of Cardiology (ESC). Endorsed by: European Association for Cardio-Thoracic Surgery (EACTS), the European Association of Nuclear Medicine (EANM).

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            Proposed modifications to the Duke criteria for the diagnosis of infective endocarditis.

            Although the sensitivity and specificity of the Duke criteria for the diagnosis of infective endocarditis (IE) have been validated by investigators from Europe and the United States, several shortcomings of this schema remain. The Duke IE database contains records collected prospectively on >800 cases of definite and possible IE since 1984. Databases on echocardiograms and on patients with Staphylococcus aureus bacteremia at Duke University Medical Center are also maintained. Analyses of these databases, our experience with the Duke criteria in clinical practice, and analysis of the work of others have led us to propose the following modifications of the Duke schema. The category "possible IE" should be defined as having at least 1 major criterion and 1 minor criterion or 3 minor criteria. The minor criterion "echocardiogram consistent with IE but not meeting major criterion" should be eliminated, given the widespread use of transesophageal echocardiography (TEE). Bacteremia due to S. aureus should be considered a major criterion, regardless of whether the infection is nosocomially acquired or whether a removable source of infection is present. Positive Q-fever serology should be changed to a major criterion.
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              Clinical presentation, etiology, and outcome of infective endocarditis in the 21st century: the International Collaboration on Endocarditis-Prospective Cohort Study.

              We sought to provide a contemporary picture of the presentation, etiology, and outcome of infective endocarditis (IE) in a large patient cohort from multiple locations worldwide. Prospective cohort study of 2781 adults with definite IE who were admitted to 58 hospitals in 25 countries from June 1, 2000, through September 1, 2005. The median age of the cohort was 57.9 (interquartile range, 43.2-71.8) years, and 72.1% had native valve IE. Most patients (77.0%) presented early in the disease (<30 days) with few of the classic clinical hallmarks of IE. Recent health care exposure was found in one-quarter of patients. Staphylococcus aureus was the most common pathogen (31.2%). The mitral (41.1%) and aortic (37.6%) valves were infected most commonly. The following complications were common: stroke (16.9%), embolization other than stroke (22.6%), heart failure (32.3%), and intracardiac abscess (14.4%). Surgical therapy was common (48.2%), and in-hospital mortality remained high (17.7%). Prosthetic valve involvement (odds ratio, 1.47; 95% confidence interval, 1.13-1.90), increasing age (1.30; 1.17-1.46 per 10-year interval), pulmonary edema (1.79; 1.39-2.30), S aureus infection (1.54; 1.14-2.08), coagulase-negative staphylococcal infection (1.50; 1.07-2.10), mitral valve vegetation (1.34; 1.06-1.68), and paravalvular complications (2.25; 1.64-3.09) were associated with an increased risk of in-hospital death, whereas viridans streptococcal infection (0.52; 0.33-0.81) and surgery (0.61; 0.44-0.83) were associated with a decreased risk. In the early 21st century, IE is more often an acute disease, characterized by a high rate of S aureus infection. Mortality remains relatively high.
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                Journal
                Mycoses
                Mycoses
                Wiley
                0933-7407
                1439-0507
                March 2022
                January 12 2022
                March 2022
                : 65
                : 3
                : 362-373
                Affiliations
                [1 ]Clinical Microbiology and Infectious Diseases Department Hospital General Universitario Gregorio Marañón Madrid Spain
                [2 ]Instituto de Investigación Sanitaria del Hospital Gregorio Marañón Madrid Spain
                [3 ]Medicine Department School of Medicine Universidad Complutense de Madrid Madrid Spain
                [4 ]Institute of Infectious DiseasesFondazione Policlinico Universitario A. Gemelli IRCCSUniversità Cattolica del Sacro Cuore Rome Italy
                [5 ]Servicio de Enfermedades Infecciosas Complejo Hospitalario Universitario La Coruña La Coruña Spain
                [6 ]Servicio de Cardiología Hospital Universitario La Paz Madrid Spain
                [7 ]Servicio de Enfermedades Infecciosas Hospital Universitario Marqués de Valdecilla Santander Spain
                [8 ]Servicio de Enfermedades Infecciosas IDIVALUniversity of Cantabria Santander Spain
                [9 ]Servicio de Enfermedades Infecciosas Hospital Universitario Virgen de las Nieves. Complejo Hospitalario de Granada Granada Spain
                [10 ]Servicio de Enfermedades Infecciosas Hospital Universitario Cruces Bilbao Spain
                [11 ]Infectious Diseases Unit San Martino Policlinico Hospital—IRCCS for Oncology and Neurosciences Genoa Italy
                [12 ]Department of Health Sciences (DISSAL) University of Genoa Genoa Italy
                [13 ]CIBERES (CB06/06/0058) Madrid Spain
                Article
                10.1111/myc.13415
                34931375
                46dce0ef-99be-4b0a-bff6-45d4ac769b20
                © 2022

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