【醫(yī)學課件】感染性心內膜炎ppt課件-展示頁
2024-10-28 06:53本頁面
【正文】 le infective endocarditis – findings consistent of IE that fall short of “definite”, but not “rejected” ? Rejected – firm alternate Dx for manifestation of IE – resolution ofmanifestations of IE, with antibiotic therapy for ? 4 days – no pathologic evidence of IE at surgery or autopsy, after antibiotic therapy for ? 4 days 7/98 13 Diagnostic (Duke) Criteria ? Major criteria – positive blood culture for IE – evidence of endocardial involvement ? Minor criteria – predisposition (heart condition or IV drug use) – fever of or higher – vascular or immunologic phenomena – microbiologic or echocardiographic evidence not meeting major criteria 7/98 14 Duke’s Major Criteria ? positive blood culture for IE – typical microanism (strep viridans, strep bovis, HACEK group, staph aureus or enterococci in the absence of a primary locus) for endocarditis from two separate blood cultures – persistently positive blood culture from: ? blood cultures drawn more than 12 hr apart, or ? all of 3 or a majority of 4 or more separate blood cultures, with first and last drqwn at least 1 hr apart 7/98 15 Duke’s Major Criteria ? Evidence of endocardial involvement – positive echocardiogram for endocarditis ? oscillating intracardiac mass on valve or supporting structure, or in the path of regurgitant jets, or on implanted material, in the absence of an alternate anatomic explanation ? abscess ? new partial dehiscence of prosthetic valve – new valvular regurgitation (increase or change in preexisting murmur not sufficient) 7/9
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