Nigul The microbiologic diagnosis of IE must be urgently improved in Chile. Read this article in English. Como Kemose et al. Am J Cardiol ; Word J Surg ; 13 1: Molecular technique identifies the pathogen responsible for a negative culture in infective endocarditis. Cardiol Clinic ; Surgical treatment of infective endocarditis.
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Suspect IE and consider the Duke Criteria in patients with: Prolonged fever Fever of Unknown Origin Fever and vascular phenomena stroke, limb ischemia, physical findings of septic emboli Persistently positive blood cultures 2 or more.
Prosthetic valves who are febrile. Injection drug users who are febrile. A pre-disposing heart condition who are febrile. Fever with a recent history of hospitalization. Should be applied to patients in whom there is a high clinical suspicion of IE. Negative cultures may be confounded by a recent history of treatment with antibiotics.
Patients with IE can have a wide range of clinical features and the diagnosis can be challenging. This criteria is sensitive for disease detection, and has a high negative predictive value. Pathological Criteria If either is positive, diagnosis is definite see Evidence for exceptions Microorganisms in a vegetation Demonstrated by culture or histologic examination of a vegetation, a vegetation that has embolized, or an intracardiac abscess specimen.
Pathologic Lesions Vegetation or intracardiac abscess confirmed by histologic examination showing active endocarditis. Evidence of endocardial involvement Echocardiogram positive for IE, abscess, new partial dehiscence of prosthetic valve, new valvular regurgitation. Note: Worsening or changing of pre-existing murmur NOT sufficient. Microbiological evidence Positive blood culture but does not meet a major criterion as noted above or serological evidence of active infection with organism consistent with IE.
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Endocarditis. Diagnóstico, criterios de Duke, tratamiento y prevención
ENDOCARDITIS INFECCIOSA CRITERIOS DE DUKE PDF