Linked Life Data

3946140

Source:http://linkedlifedata.com/resource/pubmed/id/3946140

Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
1
pubmed:dateCreated
1986-3-6
pubmed:abstractText
Right- and left-sided endocarditis are two distinct entities, both clinically and experimentally. As such, they require different clinical approaches. The accurate diagnosis of right-sided endocarditis rests largely on a high index of suspicion which is often raised in the case of an intravenous drug abuser with fever, especially when pulmonary infiltrates are detected. Two-dimensional echocardiography can be expected to confirm the diagnosis in approximately 80% of the cases. Measurement of the echocardiographically visualized vegetation provides both prognostic and therapeutic information. When the vegetation is less than 1.0 cm in diameter, antibiotic therapy can be reasonably expected to cure the infection. Despite a prolonged fever, we recommend continued medical management in these cases, as lack of response to medical management is almost exclusively seen in cases in which echocardiographically determined vegetation size is greater than or equal to 1.0 cm, perhaps because of the slower metabolic rate of bacterial colonies within these large vegetations. If, however, after 3 weeks of antibiotic therapy, fevers persist in a patient in whom two-dimensional echocardiography reveals a vegetation of greater than or equal to 1.0 cm, surgical intervention should be contemplated. Prior to such intervention, the physician must be careful to exclude other sources of fever, such as abscesses, phlebitis, and drug reactions, as indicated in Table III. Also, adequate antibiotic levels should be documented prior to surgical intervention. Because of the adverse effect on vegetation size upon the response to antibiotics, there may be a role for anticoagulation in order to potentiate the effects of the antibiotic therapy; however, this is purely speculative at present.(ABSTRACT TRUNCATED AT 250 WORDS)
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
AIM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Jan
pubmed:issn
0002-8703
pubmed:author
pubmed:issnType
Print
pubmed:volume
111
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
128-35
pubmed:dateRevised
2006-2-27
pubmed:meshHeading
pubmed:year
1986
pubmed:articleTitle
Right-sided valvular endocarditis: etiology, diagnosis, and an approach to therapy.
pubmed:publicationType
Journal Article