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Published on: January 7, 2019
Infectious endocarditis without intracardiac devices or underlying structural heart disease
Abelardo Flores-Morales1, Andrés Jacobo-Ruvalcaba1, Ariana C Acevedo-Meléndez1
1Departamento Clínico de Cardiología, Unidad Médica de Alta Especialidad, Hospital de Especialidades "Dr. Bernardo Sepúlveda Gutiérrez", Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social (IMSS), Ciudad de México.
Insights
Infectious endocarditis cases are rising, often linked to invasive procedures, even in patients without heart conditions. Early detection and multidisciplinary care are crucial for managing this complex infection.
Area of Science:
- Cardiology
- Infectious Diseases
- Echocardiography
Background:
- Infectious endocarditis (IE) diagnosis and management can be complex, particularly in patients lacking typical risk factors like intracardiac devices or structural heart disease.
- The incidence of IE may be influenced by an increase in invasive medical procedures.
Objective:
To describe clinical, microbiological and echocardiographic aspects of endocarditis in a specific group of patients without intracardiac devices or underlying structural heart disease.
Method:
Retrospective study, clinical records and echocardiographic reports were reviewed during the period 1997 to 2020. Duke's modified criteria were applied. Statistical analysis: univariate expressed in frequencies, using measures of dispersion and central tendency.
Results:
30,000 echocardiographic reports were reviewed, only 1350 had infectious endocarditis as a reason for sending, of which 248 cases were selected. The mean age was 48.1 ± 16.7 years. 140 men (56%) and 108 women (44%). The most frequent echocardiographic sign was vegetation, in 278 (93.60%), and most common location was mitral (35.55%), with a higher number of cases in the right ventricle than expected. The most common systemic disease was kidney disease, in 135 (41.08%). A case of Streptococcus thoraltensis not previously reported in Mexico was identified.
Conclusions:
The presence of infectious endocarditis has increased due to invasive in-hospital and drug procedures. Due to their complexity, multidisciplinary teams are indispensable.
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