【醫(yī)學(xué)課件】感染性心內(nèi)膜炎ppt課件-在線瀏覽
2024-12-06 06:53本頁面
【正文】 8 16 Duke’s Minor Criteria ? predisposition (predisposing heart condition or iv drug use) ? fever of or higher ? vascular phenomena (major arterial emboli, septic pulmonary infarcts, mycotic aneurysm, intracranial hemorrhage, conjunctive hemorrhages, Janeway lesions) 7/98 17 Duke’s Minor Criteria ? immunologic phenomena (glomerulonephritis, Osler’s nodes, Roth spots, rheumatoid factor) ? microbiologic evidence (positive blood culture not meeting major criteria or serologic evidence of active infection with anism consistent with IE) ? echocardiogram (consistent with IE but not meeting major criteria) 7/98 18 Risk for Endocarditis ? High risk – prosthetic cardiac valve – prior episodes of endocarditis – plex congenital cardiac defect – surgically constructed systemicpulmonary shunts or conduits 7/98 19 Risk for Endocarditis ? Moderate risk – patent ductus arteriosus – VSD, primum ASD – coarctation of the aorta – bicuspid aortic valve – hypertrophic cardiomyopathy – acquired valvular dysfunction – MVP with mitral regurgitation 7/98 20 Risk for Endocarditis ? Low risk – isolated secundum atrial septal defect – ASD, VSD, or PDA 6 months past repair – “innocent” heart murmur by auscultation in the pediatric population – “innocent” heart murmur by echocardiography in adult patients 7/98 21 Treatment ? Preantibiotic era a death sentence ? Antibiotic era – microbiologic cure in majority of patients 7/98 22 New Treatments ? Rightsided infective endocarditis due to meth
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