Infective endocarditis: a diagnostic and therapeutic challenge for the new millennium.

Alestig, Kjell,1931Gothenburg University,Göteborgs universitet,Institutionen för invärtesmedicin, Avdelningen för infektionssjukdomar,Institute of Internal Medicine, Dept of Infectious Diseases (author)

This review on infective endocarditis (IE) is based on clinical studies carried out in Göteborg since 1984, data obtained from a Swedish national registry of IE since 1995 and existing literature. IE is still a great challenge in medicine, although improved bacteriological and echocardiographical techniques have facilitated diagnosis. In Sweden the incidence of IE is about 6 per 100,000 inhabitants a year. During recent decades IE has changed character. Patients are older, fever is often the only major symptom and a new murmur is less frequent. Streptococci, including viridans species and staphylococci, are still the most common bacteria found. Antibiotic treatment for 4-6 weeks may reduce mortality of IE to 30-50%. For further reduction, heart surgery is necessary in 20-25% of patients in order to remove infected tissues and restore valve function. Rapid diagnosis, careful antibiotic treatment and optimal surgery may reduce mortality associated with treatment to 10%. Antibiotic treatment is still mainly empiric. Penicillin and aminoglycoside for 2 weeks only seem to be effective in uncomplicated IE caused by alpha-streptococci. Otherwise, 4 weeks of treatment is needed, but aminoglycoside treatment may be reduced to 1 week in general and 2 weeks for enterococcal infections.

Hogevik, HarrietGothenburg University,Göteborgs universitet,Institutionen för invärtesmedicin, Avdelningen för infektionssjukdomar,Institute of Internal Medicine, Dept of Infectious Diseases (author)
Olaison, Lars,1949Gothenburg University,Göteborgs universitet,Institutionen för invärtesmedicin, Avdelningen för infektionssjukdomar,Institute of Internal Medicine, Dept of Infectious Diseases(Swepub:gu)xolala (author)
Göteborgs universitetInstitutionen för invärtesmedicin, Avdelningen för infektionssjukdomar (creator_code:org_t)

In:Scandinavian journal of infectious diseases: Informa UK Limited32:4, s. 343-560036-55481651-1980

By the author/editor: Alestig, Kjell, ...; Hogevik, Harriet; Olaison, Lars, 1 ...

About the subject

MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Infectious Medic ...

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