Cargando…
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...
Autores principales: | , , , , , , , |
---|---|
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 |
_version_ | 1783519209992486912 |
---|---|
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. |
format | Online Article Text |
id | pubmed-7141516 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
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 |
work_keys_str_mv | AT kreitmannlouis clinicalcharacteristicsandoutcomeofpatientswithinfectiveendocarditisdiagnosedinadepartmentofinternalmedicine AT montaignedavid clinicalcharacteristicsandoutcomeofpatientswithinfectiveendocarditisdiagnosedinadepartmentofinternalmedicine AT launaydavid clinicalcharacteristicsandoutcomeofpatientswithinfectiveendocarditisdiagnosedinadepartmentofinternalmedicine AT morellduboissandrine clinicalcharacteristicsandoutcomeofpatientswithinfectiveendocarditisdiagnosedinadepartmentofinternalmedicine AT maillardhelene clinicalcharacteristicsandoutcomeofpatientswithinfectiveendocarditisdiagnosedinadepartmentofinternalmedicine AT lambertmarc clinicalcharacteristicsandoutcomeofpatientswithinfectiveendocarditisdiagnosedinadepartmentofinternalmedicine AT hachullaeric clinicalcharacteristicsandoutcomeofpatientswithinfectiveendocarditisdiagnosedinadepartmentofinternalmedicine AT sobanskivincent clinicalcharacteristicsandoutcomeofpatientswithinfectiveendocarditisdiagnosedinadepartmentofinternalmedicine |