Engelsk titel: Incidence and diagnosis of infectious endocarditis in Frederiksborg County, 1990-2000
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Författare:
Foghsgaard J
;
Ammentorp Pedersen S
;
Launbjerg J
Email: jakobfoghsgaard@get2net.dk
Språk: Dan
Antal referenser: 16
Dokumenttyp:
Artikel
UI-nummer: 04061393
Sammanfattning
Introduction: Our aim was to estimate the incidence of infectious endocarditis (IE) and to evaluate Duke's diagnostic criteria as a diagnostic tool. Materials and methods: Clinical data were retrospectively obtained from 135 consecutive case records with a clinical diagnosis of IE in the period 1990-2000 in a specified region of Denmark. The Duke diagnostic criteria were applied in each case, and the patients were classified according to Duke as having definite, possible or rejected IE. Results: The incidence of IE was 3.5/100.000 per year, which was in accordance with previous studies. A higher incidence was observed among elderly patients. In none of the cases was the diagnosis of IE rejected following the retrospective analysis with Duke's criteria. 50% were diagnosed as definite IE, 50% as possible IE. In the group with prosthetic valve IE (PVE), only 55% were defined as definite IE despite the fact that prosthetic valves are thought to facilitate the diagnostic process in general. Significant echocardiographic findings were observed among only 14% of patients with PVE. 20% had culture-negative IE (CNE), and none of the patients in this group was classified as having definite IE. The two minor criteria concerning vascular and immunological manifestations were observed in only 17% of the cases. Discussion: The increase in diagnosed CNE and PVE and the absence of focus on minor diagnostic criteria emphasize the importance of well-defined, systematic use of diagnostic guidelines and the necessity of liberal use of trans-esophageal echocardiography in the diagnostic process.