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Influence of vegetation size on clinical outcome of right sided infective endocarditis

, : Influence of vegetation size on clinical outcome of right sided infective endocarditis. American Journal of Medicine 80(2): 165-171

Endocarditis involving right-sided valvular structures is largely a disease of intravenous drug abusers. The majority of these patients respond to antibiotic therapy with clearing of their bacteremia and preservation of their hemodynamic status. This study evaluated the prognostic value of echocardiographically determined vegetation size in 23 episodes of right-sided valvular endocarditis in 21 patients. Right-sided vegetations were visualized in 19 of 23 episodes (83 percent). Of these, a vegetation of 1.0 cm or greater was found in 11. No patient with an echocardiographically determined vegetation size of less than 1.0 cm required surgery, whereas four of 11 (36 percent) of those episodes in which the vegetation size was 1.0 cm or greater required surgery for persistent pyrexia (p < 0.05). In all patients requiring surgery, a bioprosthetic tricuspid value was placed at the time of initial surgery and in no patient did early reinfection occur. This study reconfirms the benign prognosis of right-sided valvular endocarditis. Further, although vegetations of less than 1.0 cm identify those patients who will respond to medical therapy, echocardiographically documented vegetations of 1.0 cm or greater are associated with a significantly lower response rate to appropriate medical therapy. The association of fever the persists for more than three weeks in the absence of another source of infection with an echocardiographically demonstrable right-sided vegetation of 1 cm or more identifies those patients who will require surgical intervention. Finally, tricuspid value replacement can be performed at the time of initial surgery without undue concern for early reinfection or valve dysfunction.


PMID: 3777005

Other references

Beecher D.J.; Fink K.; Macmillan J.D., 1988: Evaluation of a colony immunoblot assay for detection of the diarrheal toxin of bacillus cereus. Abstracts of the Annual Meeting of the American Society for Microbiology 88: 280

Fan QingShu; Zhao JianCheng; Y.S.uHong, 2004: Analyse on application value and protection countermeasures of bryophyte resource in China. The application of bryophytes in medicine, and in ecological and environmental protection, horticulture and agriculture are analysed. The present status of bryophyte resources and conservation efforts in China is discussed.

Kongkeaw, C.; Dilokthornsakul, P.; Thanarangsarit, P.; Limpeanchob, N.; Norman Scholfield, C., 2014: Meta-analysis of randomized controlled trials on cognitive effects of Bacopa monnieri extract. Bacopa monnieri has a long history in Ayurvedic medicine for neurological and behavioral defects. To assess its efficacy in improving cognitive function. MEDLINE, EMBASE, CINAHL, AMED, Cochrane Central of clinical trial, WHO registry, Thai Medical...

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Gerna, G.; Gerna, M.T.; Gullino, M.; Achilli, G., 1975: Late stages in the replicative cycle of human cytomegaloviruses in diploid cells. Ultrastructural study. An ultrastructural study of late stages of the replicative cycle of human cytomegalovirus (CMV) in human embryo fibroblasts cell cultures has been performed. Nucleocapsids are observed only inside the intranuclear inclusion. They mature apparently...

Merwin I., 1991: Alternative orchard groundcover management systems influence early apple yields and mortality. Hortscience 26(5): 482

Hyakumachi, M.K.geyama, K.I.egami, H., 1992: Energy stress in relation to germinabiltiy and virulence of root infecting fungi. NATO ASI series: Series A: Life sciences30(230): 327-330

Varlet, V.; Smith, F.; Augsburger, M., 2014: Indirect hydrogen analysis by gas chromatography coupled to mass spectrometry (GC-MS). Gas chromatography (GC) is an analytical tool very useful to investigate the composition of gaseous mixtures. The different gases are separated by specific columns but, if hydrogen (H2 ) is present in the sample, its detection can be performed by...

Wells, C., 1973: The palaeopathology of bone disease. Practitioner 210(257): 384-391

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