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Clinical Characteristics and Outcome of Patients with Infective Endocarditis Diagnosed in a Department of Internal Medicine

Clinical manifestations of infective endocarditis (IE) can be highly non-specific. Our objective was to describe the clinical characteristics of patients initially referred to a department of internal medicine for a diagnostic work-up, and eventually diagnosed with IE. We retrospectively retrieved a...

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Autores principales: Kreitmann, Louis, Montaigne, David, Launay, David, Morell-Dubois, Sandrine, Maillard, Hélène, Lambert, Marc, Hachulla, Eric, Sobanski, Vincent
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7141516/
https://www.ncbi.nlm.nih.gov/pubmed/32245196
http://dx.doi.org/10.3390/jcm9030864
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author Kreitmann, Louis
Montaigne, David
Launay, David
Morell-Dubois, Sandrine
Maillard, Hélène
Lambert, Marc
Hachulla, Eric
Sobanski, Vincent
author_facet Kreitmann, Louis
Montaigne, David
Launay, David
Morell-Dubois, Sandrine
Maillard, Hélène
Lambert, Marc
Hachulla, Eric
Sobanski, Vincent
author_sort Kreitmann, Louis
collection PubMed
description Clinical manifestations of infective endocarditis (IE) can be highly non-specific. Our objective was to describe the clinical characteristics of patients initially referred to a department of internal medicine for a diagnostic work-up, and eventually diagnosed with IE. We retrospectively retrieved adult patients admitted to the department of internal medicine at Lille University Hospital between 2004 and 2015 who fulfilled Duke Classification criteria for definite IE. Thirty-five patients were included. The most frequently involved bacteria were non-hemolytic streptococci. Most patients presented with various systemic, cardiac, embolic, rheumatic, and immunological findings, with no sign or symptom displaying high sensitivity. The first transthoracic echocardiogram was negative in 42% of patients. Furthermore, definite diagnosis required performing at least 2 transesophageal examinations in 24% of patients. We observed a trend towards decreased survival in the subgroup of patients in whom the delay between onset of symptoms and diagnosis was >30 days. In conclusion, patients who are initially referred to internal medicine for a diagnosis work-up and who are ultimately diagnosed with IE have non-specific symptoms and a high percentage of initial normal echocardiography. Those patients require prolonged echocardiographic monitoring as a prolonged delay in diagnosis is associated with poorer outcomes such as death.
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spelling pubmed-71415162020-04-15 Clinical Characteristics and Outcome of Patients with Infective Endocarditis Diagnosed in a Department of Internal Medicine Kreitmann, Louis Montaigne, David Launay, David Morell-Dubois, Sandrine Maillard, Hélène Lambert, Marc Hachulla, Eric Sobanski, Vincent J Clin Med Article Clinical manifestations of infective endocarditis (IE) can be highly non-specific. Our objective was to describe the clinical characteristics of patients initially referred to a department of internal medicine for a diagnostic work-up, and eventually diagnosed with IE. We retrospectively retrieved adult patients admitted to the department of internal medicine at Lille University Hospital between 2004 and 2015 who fulfilled Duke Classification criteria for definite IE. Thirty-five patients were included. The most frequently involved bacteria were non-hemolytic streptococci. Most patients presented with various systemic, cardiac, embolic, rheumatic, and immunological findings, with no sign or symptom displaying high sensitivity. The first transthoracic echocardiogram was negative in 42% of patients. Furthermore, definite diagnosis required performing at least 2 transesophageal examinations in 24% of patients. We observed a trend towards decreased survival in the subgroup of patients in whom the delay between onset of symptoms and diagnosis was >30 days. In conclusion, patients who are initially referred to internal medicine for a diagnosis work-up and who are ultimately diagnosed with IE have non-specific symptoms and a high percentage of initial normal echocardiography. Those patients require prolonged echocardiographic monitoring as a prolonged delay in diagnosis is associated with poorer outcomes such as death. MDPI 2020-03-21 /pmc/articles/PMC7141516/ /pubmed/32245196 http://dx.doi.org/10.3390/jcm9030864 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Kreitmann, Louis
Montaigne, David
Launay, David
Morell-Dubois, Sandrine
Maillard, Hélène
Lambert, Marc
Hachulla, Eric
Sobanski, Vincent
Clinical Characteristics and Outcome of Patients with Infective Endocarditis Diagnosed in a Department of Internal Medicine
title Clinical Characteristics and Outcome of Patients with Infective Endocarditis Diagnosed in a Department of Internal Medicine
title_full Clinical Characteristics and Outcome of Patients with Infective Endocarditis Diagnosed in a Department of Internal Medicine
title_fullStr Clinical Characteristics and Outcome of Patients with Infective Endocarditis Diagnosed in a Department of Internal Medicine
title_full_unstemmed Clinical Characteristics and Outcome of Patients with Infective Endocarditis Diagnosed in a Department of Internal Medicine
title_short Clinical Characteristics and Outcome of Patients with Infective Endocarditis Diagnosed in a Department of Internal Medicine
title_sort clinical characteristics and outcome of patients with infective endocarditis diagnosed in a department of internal medicine
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7141516/
https://www.ncbi.nlm.nih.gov/pubmed/32245196
http://dx.doi.org/10.3390/jcm9030864
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