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Related Experiment Videos

Persistent fever in association with infective endocarditis.

E A Blumberg1, N Robbins, A Adimora

  • 1Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York.

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|December 1, 1992
PubMed
Summary

Persistent fever in endocarditis patients despite antibiotics often signals complications. This study highlights that prolonged fever indicates serious issues, requiring further evaluation and intervention for better outcomes.

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Area of Science:

  • Infectious Diseases
  • Cardiology
  • Internal Medicine

Background:

  • Persistent fever despite appropriate antimicrobial therapy for endocarditis is a concerning clinical sign.
  • Endocarditis is a serious infection of the heart valves or lining.

Purpose of the Study:

  • To evaluate the significance and implications of persistent fever in patients with endocarditis.
  • To identify common causes and complications associated with prolonged fever in endocarditis.

Main Methods:

  • Retrospective review of patients with endocarditis and prolonged fever (> or = 2 weeks) at three hospital affiliates.
  • Comparison with a matched cohort of endocarditis patients without prolonged fever.
  • Analysis of fever duration, causes, cardiac involvement, surgical interventions, complications, and mortality.

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Main Results:

  • Persistent fever in endocarditis patients was associated with longer fever duration (median 35 days) and cardiac complications like myocardial abscesses.
  • Higher rates of cardiac surgery (16 vs. 2) and nosocomial complications (22 vs. 5) were observed in the persistent fever group.
  • Mortality was higher in patients with persistent fever (6 vs. 0), primarily due to endocarditis-related complications.

Conclusions:

  • Persistent fever in endocarditis frequently indicates complicated disease, including cardiac abscesses and increased risk of surgery and nosocomial infections.
  • An approach for evaluating patients with persistent fever in endocarditis is presented.
  • Prompt recognition and thorough evaluation are crucial for managing complicated endocarditis.