Diapositive in formato pdf - GrG

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The clinical presentation of IE in elderly individuals may be nonspecific. Several articles have emphasized that atypical presentations of IE are quite common among elderly patients and that diagnosis is frequently delayed. The presenting manifestations of IE in the older patients are constitutional symptoms, such as lethargy, fatigue, , malaise, anorexia, and weight loss, all of which can be attributed to aging and other disorders that are more likely to occur among elderly persons. The febrile response is often blunted in older patients. Some elderly patients manifest worsening of congestive heart failure. New cardiac murmurs (caused by progressive valvular damage and valvular incompetence) are highly indicative of IE. However, approximately one-third of patients with tricuspid valve disease and patients who have only mural involvement may not have a pathologic murmur on initial presentation. In addition, heart murmurs in elderly individuals may be erroneously attributed to the underlying valvular calcification and, therefore, neglected. Alternatively, IE in elderly persons may present with a stroke syndrome, rheumatologic complaints, or peripheral nervous system abnormalities. Musculoskeletal manifestations of IE include backache, arthralgia, septic arthritis, and osteomyelitis.
Diagnosi: esame obiettivo ed anamnesi Ricerca dei segni e sintomi (es: febbre persistente, soffio valvolare di nuova insorgenza, , etc) Individuazione delle persone a rischio (es: difetti valvolari noti, protesi valvolare, recenti procedure invasive al cavo orale, apparati genito-urinario o gastro-enterico enterico, recente impianto di protesi valvolare o PM)
Page 1 and 2: Journal Club-GRG Venerdi 9-11-2007
Page 3 and 4: Endocardite trombotica non batteric
Page 5 and 6: Difetti valvolari 25-70% Native Val
Page 7 and 8: RR di endocardite infettiva RISCHIO
Page 9 and 10: Eziologia nella popolazione adulta
Page 12 and 13: Patogenesi L’endotelio non danneg
Page 14 and 15: Conversione in endocardite batteric
Page 16 and 17: Manifestazioni cliniche Sistemiche
Page 18 and 19: Clinica L’ intervallo tra batteri
Page 20 and 21: Manifestazioni extracardiache: le e
Page 22 and 23: Lesioni di Janeway
Page 24 and 25: Noduli sottocutanei di Osler
Page 26 and 27: Macchie di Roth
Page 30 and 31: Diagnosi: esami di laboratorio Repe
Page 32 and 33: Circulation 2003;108:2015-2031 2031
Page 34 and 35: Duke Criteria (1994-2000) Si basano
Page 36 and 37: Duke Criteria: Criteri minori Fatto
Page 38 and 39: Obiettivi della terapia 1. Eradicar
Page 41 and 42: Terapia Antibiotica Fattori conside
Page 44: Terapia antibiotica mirata
Page 51 and 52: Outcome del trattamento: sopravvive
Page 53 and 54: Prevenzione: profilassi per specifi
Page 57: High tech but high touch La prevenz

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