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[The clinical and pathological features of patients with infective endocarditis diagnosed at autopsy]

Y Jia, F Fang, H Wang1

  • 1Department of Cardiology, Beijing Hospital, Beijing 100730, China.

Zhonghua Nei Ke Za Zhi
|October 18, 2017
PubMed

Insights

Infective endocarditis (IE) is often misdiagnosed, especially in older patients with comorbidities like malignancies. Early suspicion and diagnostic tests like echocardiography and blood cultures are crucial for timely IE diagnosis.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Pathology

Background:

  • Infective endocarditis (IE) is a serious infection affecting heart valves.
  • Misdiagnosis of IE can lead to delayed treatment and poorer outcomes.
  • Understanding IE characteristics and misdiagnosis patterns is vital for improving patient care.

Purpose of the Study:

  • To investigate the clinical features and common misdiagnosis scenarios of infective endocarditis (IE).
  • To compare characteristics of IE patients diagnosed via autopsy with those diagnosed conventionally.
  • To identify factors contributing to IE misdiagnosis.

Main Methods:

  • Retrospective analysis of clinical and pathological data from 15 autopsy-diagnosed IE cases.
  • Comparison of autopsy cases with a control group of 29 regularly diagnosed IE patients.
  • Evaluation of diagnostic methods, comorbidities, and presenting symptoms in misdiagnosed IE cases.

Main Results:

  • Left heart involvement was predominant (93.3%) in autopsy cases.
  • Arterial embolism (66.7%), pneumonia (60.0%), and malignancies (46.7%) were common comorbidities.
  • Misdiagnosed IE cases were older, more frequently had malignancies or deep vein catheterization, and rarely presented with fever or cardiac murmur.

Conclusions:

  • Infective endocarditis (IE) should be suspected in at-risk patients, even without typical symptoms like fever or murmur.
  • Echocardiography and blood cultures are essential screening tools for IE diagnosis.
  • Improved diagnostic strategies are needed to reduce IE misdiagnosis rates.
Keywords:
AutopsyEndocarditis, bacterial

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