Abstract
A firm diagnosis of infective endocarditis is difficult to establish. Clinicians often face a decision-making dilemma about whether to treat a patient presenting with some features that suggest endocarditis. This article summarizes both the previous and the recently proposed criteria for the diagnosis of infective endocarditis, and reviews the efficacy of the new criteria. The authors also discuss the experience at The Toronto Hospital, Toronto, Ontario, with this disease, paying specific attention to the application of the new criteria in the diagnostic process.
Highlights
A firm diagnosis of infective endocarditis is difficult to establish
Infective endocarditis (IE) is a condition in which microbial infection occurs on the endothelial surface of the heart
Trained physicians often associate the presence of a febrile illness in a patient with a prosthetic heart valve with endocarditis and may subject patients to unnecessary invasive studies and therapy
Summary
Clinicians often face a decision-making dilemma about whether to treat a patient presenting with some features that suggest endocarditis This article summarizes both the previous and the recently proposed criteria for the diagnosis of infective endocarditis, and reviews the efficacy of the new criteria. Infective endocarditis (IE) is a condition in which microbial infection occurs on the endothelial surface of the heart It is characterized by the formation of valvular vegetations, fenestration, abscess and dehiscence of prosthetic valves. Negative or intermittently positive blood cultures¶ plus three of the following: · fever · new regurgitant murmur · vascular phenomena Possible A. Positive blood cultures, plus one of the following: · predisposing heart disease · vascular phenomena B. Negative or intermittently positive blood cultures with all three of the following: · fever · predisposing heart disease · vascular phenomena C. For Viridans streptococcus cases only: at least two positive blood cultures without an extracardiac source and fever
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