Talk:Endocarditis
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[edit] TEE
TEE recommended for patients with prosthetic valves, rated at least "possible IE" by clinical criteria, or complicated IE [paravalvular abscess]; TTE as first test in other patient
Definition of Terms Used in the Modified Duke Criteria for the Diagnosis of Infective EndocarditisMajor criteria
Blood culture positive for IE
Typical microorganisms consistent with IE from 2 separate blood cultures: Viridans streptococci, Streptococcus bovis, HACEK group, Staphylococcus aureus; or community-acquired enterococci in the absence of a primary focus; or
Microorganisms consistent with IE from persistently positive blood cultures defined as follows: At least 2 positive cultures of blood samples drawn >12 h apart; or all of 3 or a majority of 4 separate cultures of blood (with first and last sample drawn at least 1 h apart)
Single positive blood culture for Coxiella burnetii or anti–phase 1 IgG antibody titer >1:800
Evidence of endocardial involvement
Echocardiogram positive for IE (TEE recommended for patients with prosthetic valves, rated at least "possible IE" by clinical criteria, or complicated IE [paravalvular abscess]; TTE as first test in other patients) defined as follows: oscillating intracardiac mass on valve or supporting structures, in the path of regurgitant jets, or on implanted material in the absence of an alternative anatomic explanation; or abscess; or new partial dehiscence of prosthetic valve; new valvular regurgitation (worsening or changing or preexisting murmur not sufficient)
Minor criteria
Predisposition, predisposing heart condition, or IDU Fever, temperature >38°C Vascular phenomena, major arterial emboli, septic pulmonary infarcts, mycotic aneurysm, intracranial hemorrhage, conjunctival hemorrhages, and Janeway’s lesions Immunologic phenomena: glomerulonephritis, Osler’s nodes, Roth’s spots, and rheumatoid factor 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 Echocardiographic minor criteria eliminated
Modifications shown in boldface.
- Excludes single positive cultures for coagulase-negative staphylococci and organisms that do not cause endocarditis.
TEE indicates transesophageal echocardiography; TTE, transthoracic echocardiography. Reprinted with permission from Clinical Infectious Diseases.35 Copyright 2000, The University of Chicago Press.
Definition of Infective Endocarditis According to the Modified Duke CriteriaDefinite infective endocarditis
Pathological criteria
Microorganisms demonstrated by culture or histological examination of a vegetation, a vegetation that has embolized, or an intracardiac abscess specimen; or
Pathological lesions; vegetation or intracardiac abscess confirmed by histological examination showing active endocarditis
Clinical criteria
2 major criteria; or
1 major criterion and 3 minor criteria; or
5 minor criteria
Possible IE
1 major criterion and 1 minor criterion; or
3 minor criteria
Rejected
Firm alternative diagnosis explaining evidence of IE; or
Resolution of IE syndrome with antibiotic therapy for <4 days; or
No pathological evidence of IE at surgery or autopsy, with antibiotic therapy for <4 days; or
Does not meet criteria for possible IE as above
Modifications shown in boldface. Reprinted with permission from Clinical Infectious Diseases.35 Copyright 2000, The University of Chicago Press.
What is the likely hood of mortality from this Endocarditis, When there is a mass a deterioration and bone loss of the ribs, Also the mass is near the lung —Preceding unsigned comment added by 67.181.19.144 (talk) 05:49, 27 May 2008 (UTC)
