Keywords: acute infective endocarditis
Acute infective endocarditis, major clinical manifestations of sepsis, especially no heart murmur, the disease is often the primary infection conceal, easy to misdiagnosis, fever for more than a week, you should pay attention to changes in cardiac auscultation, skin bleeding point and embolic phenomena. Often need to identify with influenza, acute arthritis, acute purulent meningitis, acute pyelonephritis. In recent years, due to the progress of the surgery of cardiac surgery and antibiotics widely used, not typical or special types of infective endocarditis increasing trend, such as artificial valve replacement surgery, hemodialysis or after surgical correction of congenital heart disease are increase the chances of infection of the endocardium, postoperative fever patients should be vigilant.
Often caused by virulent bacteria, Staphylococcus aureus, hemolytic streptococcus, pneumococcus, influenza bacillus, Proteus, and E. coli is more common. These bacteria are virulent, acute onset, severe illness, often secondary to other parts of the infection as part of systemic infection, such as meningitis, pneumonia, blood clots, phlebitis, sometimes accompanied by other organs of metastatic purulent lesions. It usually occurs in the normal heart.
Acute infective endocarditis, 50-60% occur in the normal heart valves, valves and tendons can be perforated ulcer, chordae rupture and large brittle vegetation, vegetation off bacterial emboli, causing embolism and migration abscess.
Mainly: ① sepsis performance, rapid onset, rapid progression, high fever, chills, fatigue and other symptoms of poisoning. (2) skin bleeding and embolic phenomena. ③ cardiac performance early multi murmur, the individual onset shortly after a new murmur and quickly becomes a high-profile, rough, and heart failure. The ④ staph infections can be complicated by lung abscess, brain abscess and other migration abscess, cough, difficulty breathing, convulsions, paralysis and other. ⑤ increase in white blood cells, progressive anemia, multiple consecutive higher rate of positive blood cultures.
The prognosis of this disease depends on the treatment of morning and evening, antibiotics primary bacterial ability to control the degree of heart valve damage and resistance in patients with Staphylococcus aureus, hemolytic streptococcus, pneumococcus, gram-negative bacilli, bacterial virulence and strong, rapid infection valve leaflets injury, aggravated during antibiotic therapy of heart failure or the original heart failure, changing new murmur or murmur, embolic phenomena, etc., are infected can not control signs need to consider replacing antibiotics. To strengthen supportive therapy, to improve the general situation, the fight for the surgery as soon as possible to delay too long, the condition may be progressive deterioration, often lose the chance of operation.