9. Medical treatment of enterococcal endocarditis is challenging and difficult because of the increasing resistance of enterococci to multiple antibiotics.15,16 Enterococcal organisms are uniformly resistant to a concentration of penicillin G of 0.1 μg per mL. 0000005443 00000 n al. Because of the serious consequences of untreated bacterial endocarditis, many patients are treated initially as if they have bacterial endocarditis until additional information is obtained that might resolve the diagnostic dilemma. Dajani AS, Reprints are not available from the authors. 0000014934 00000 n Most cases of bacterial endocarditis involve infection with viridans streptococci, enterococci, coagulase-positive staphylococci or coagulase-negative staphylococci. Postgrad Med. 2007;116:1736-1754. Blaiss MS. Taubert KA, 1994;96:200–9. 1985;254:1199–202. Abrutyn E, Already have an account? Review of 65 cases of infective endocarditis in Dunedin Public Hospital. Surgical treatment of infective endocarditis. Want to use this article elsewhere? Pompili VJ, Don't miss a single issue. Generally, a four-week course of therapy is indicated for patients with symptoms of less than three months' duration and a six-week course of therapy is appropriate for patients with symptoms lasting longer than three months. Diagnostic and therapeutic approach. 13. As soon as the blood cultures have been secured the patient is started on intravenous (IV) antibiotic therapy (broad spectrum), covering as many as possible of suspected bacterial species. afpserv@aafp.org for copyright questions and/or permission requests. Acute infective endocarditis. * From the Department of Medicine, Harvard Medical School, and the Medical Clinic, Peter Bent Brigham Hospital. Blood tests. Acar J, 17. infection and inflammation of the heart valves and the inner lining of the heart chambers The addition of gentamicin for the first three to five days may accelerate clearing of bacteremia. Vancomycin should be substituted for penicillin when high-level resistance is present. 1995;76:933–6. Kubak BM, ** In this period, 1 patient with patent ductus arteriosus and bacterial endocarditis received penicillin, but was operated on and is not included in this series. / %%EOF Bayer AS, 0000018757 00000 n Gill MV, 1. Contact et al. New criteria for diagnosis of infective endocarditis: utilization of specific echocardiographic findings. Appetite suppressants and valvular heart disease. Nishimura, RA, et. Habib G, et.
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