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Der Klinikarzt 2018; 47(06): 266-270
DOI: 10.1055/a-0638-5776
Schwerpunkt
© Georg Thieme Verlag Stuttgart · New York

Endokarditis

Diagnostische und therapeutische Besonderheiten einer komplikationsträchtigen Infektion
Siegbert Rieg
Abteilung Infektiologie, Klinik für Innere Medizin II, Universitätsklinikum Freiburg
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Publication History

Publication Date:
25 June 2018 (online)

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Zusammenfassung

Die infektiöse Endokarditis stellt eine schwerwiegende und komplikationsträchtige Infektion mit erheblichen Sterblichkeitsraten dar. Es hat sich ein epidemiologischer Wandel hin zu Gesundheitssystem-assoziierter Endokarditis vollzogen, Haupterreger sind heute Staphylokokken. Bei hochgradigem Verdacht auf Vorliegen einer Endokarditis bleibt die transösophageale Echokardiografie der Standard in der bildgebenden Diagnostik. Neuere bildgebende Methoden wie 3D-TEE, Kardio-CT, FDG-PET/CT bleiben spezifischen Fragestellungen vorbehalten. Die 2015 veröffentlichten Leitlinien der European Society of Cardiology (ESC) beinhalten im Vergleich zur zeitgleich veröffentlichten Leitlinie der Amercian Heart Association (AHA) einige umstrittene Empfehlungen, insbesondere im Hinblick auf die Antibiotika-Therapie der Staphylokokken-Endokarditis. Propionibacterium acnes und Coxiella burnetii stellen Endokarditis-Erreger dar, für die diagnostische und therapeutische Besonderheiten gelten.

 

  • Literatur

  • 1 Rieg S. [Endocarditis – an update]. Dtsch Med Wochenschr 2015; 140: 1817-1820
    Article in Thieme ConnectPubMedGoogle Scholar
  • 2 Cahill TJ, Prendergast BD. Infective endocarditis. Lancet 2016; 387: 882-893
    CrossrefPubMedGoogle Scholar
  • 3 Cahill TJ, Baddour LM, Habib G. et al. Challenges in infective endocarditis. J Am Coll Cardiol 2017; 69: 325-344
    CrossrefPubMedGoogle Scholar
  • 4 Østergaard L, Valeur N, Ihlemann N. et al. Incidence and factors associated with infective endocarditis in patients undergoing left-sided heart valve replacement. Eur Heart J. 2018 Mar 23. doi: 10.1093/eurheartj/ehy153. [Epub ahead of print]
    PubMedGoogle Scholar
  • 5 Habib G, Lancellotti P, Antunes MJ. et al. 2015 ESC Guidelines for the management of infective endocarditis. Eur Heart J 2015; 36: 3075-3128
    CrossrefPubMedGoogle Scholar
  • 6 Baddour LM, Wilson WR, Bayer AS. et al. Infective endocarditis in adults: diagnosis, antimicrobial therapy, and management of complications: a scientific statement for healthcare professionals from the American Heart Association. Circulation 2015; 132: 1435-1486
    CrossrefPubMedGoogle Scholar
  • 7 Østergaard L, Valeur N, Bundgaard H. et al. Temporal changes in infective endocarditis guidelines during the last 12 years: high-level evidence needed. Am Heart J 2017; 193: 70-75
    CrossrefPubMedGoogle Scholar
  • 8 Li JS, Sexton DJ, Mick N. et al. Proposed modifications to the Duke criteria for the diagnosis of infective endocarditis. Clin Infect Dis 2000; 30: 633-638
    CrossrefPubMedGoogle Scholar
  • 9 Fournier PE, Thuny F, Richet H. et al. Comprehensive diagnostic strategy for blood culture-negative endocarditis: a prospective study of 819 new cases. Clin Infect Dis 2010; 51: 131-140
    CrossrefPubMedGoogle Scholar
  • 10 Liesman RM, Pritt BS, Maleszewski JJ. et al. Laboratory diagnosis of infective endocarditis. J Clin Microbiol 2017; 55: 2599-2608
    CrossrefPubMedGoogle Scholar
  • 11 Pfister R, Betton Y, Freyhaus HT. et al. Three-dimensional compared to two-dimensional transesophageal echocardiography for diagnosis of infective endocarditis. Infection 2016; 44: 725-731
    CrossrefPubMedGoogle Scholar
  • 12 Sarrazin JF, Philippon F, Trottier M. et al. Role of radionuclide imaging for diagnosis of device and prosthetic valve infections. World J Cardiol 2016; 8: 534-546
    CrossrefPubMedGoogle Scholar
  • 13 Kouijzer IJE, Berrevoets MAH, Aarntzen EHJG. et al. 18F-fluorodeoxyglucose positron-emission tomography combined with computed tomography as a diagnostic tool in native valve endocarditis. Nucl Med Commun. 2018 May 14. doi: 10.1097/MNM.0000000000000864. [Epub ahead of print]
    PubMedGoogle Scholar
  • 14 Beganovic M, Luther MK, Rice LB. et al. A review of combination antimicrobial therapy for Enterococcus faecalis bloodstream infections and infective endocarditis. Clin Infect Dis. 2018 Jan 30. doi: 10.1093/cid/ciy064. [Epub ahead of print]
    PubMedGoogle Scholar
  • 15 Casalta JP, Zaratzian C, Hubert S. et al. Treatment of Staphylococcus aureus endocarditis with high doses of trimethoprim/sulfamethoxazole and clindamycin-Preliminary report. Int J Antimicrob Agents 2013; 42: 190-191
    CrossrefPubMedGoogle Scholar
  • 16 Pericàs JM, Cervera C, Moreno A. et al. Outcome of Enterococcus faecalis infective endocarditis according to the length of antibiotic therapy: preliminary data from a cohort of 78 patients. PLoS One 2018; 13: e0192387
    CrossrefPubMedGoogle Scholar
  • 17 Banzon JM, Rehm SJ, Gordon SM. et al. Propionibacterium acnes endocarditis: a case series. Clin Microbiol Infect 2017; 23: 396-399
    CrossrefPubMedGoogle Scholar
  • 18 Lindell F, Söderquist B, Sundman K. et al. Prosthetic valve endocarditis caused by Propionibacterium species: a national registry-based study of 51 Swedish cases. Eur J Clin Microbiol Infect Dis. 2018 Jan 29. doi: 10.1007/s10096–017–3172–8. [Epub ahead of print]
    PubMedGoogle Scholar
  • 19 Gunn TM, Raz GM, Turek JW. et al. Cardiac manifestations of Q fever infection: case series and a review of the literature. J Card Surg 2013; 28: 233-237
    CrossrefPubMedGoogle Scholar
  • 20 Karhof S, van Roeden SE, Oosterheert JJ. et al. Primary and secondary arterial fistulas during chronic Q fever. J Vasc Surg. 2018 Apr 20. pii: S0741–5214(18)30397–5. doi: 10.1016/j.jvs.2018.01.044. [Epub ahead of print]
    PubMedGoogle Scholar
  • 21 Alende-Castro V, Macía-Rodríguez C, Novo-Veleiro I. et al. Q fever in Spain: Description of a new series, and systematic review. PLoS Negl Trop Dis 2018; 12: e0006338
    CrossrefPubMedGoogle Scholar
  • 22 Armstrong MR, McCarthy KL, Horvath RL. A contemporary 16-year review of Coxiella burnetii infective endocarditis in a tertiary cardiac center in Queensland, Australia. Infect Dis (Lond) 2018; Mar 8 1-8
    PubMedGoogle Scholar