Perivalvular Ectension of Infection in Patients with Infectious
          Endocarditis

Carpenter, John L.

doi:10.1093/clinids/13.1.127

Cited by 58 publications

(33 citation statements)

References 50 publications

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“…300 Periannular extension is common, occurring in 10% to 40% of all NVE and complicating aortic IE more commonly than mitral or tricuspid IE. [301][302][303][304] Periannular infection is of even greater concern with PVE, occurring in 56% to 100% of patients. 298,302 Perivalvular abscesses are particularly common with prosthetic valves because the annulus, rather than the leaflet, is the usual primary site of infection, especially in early PVE and on bioprosthetic valves.…”

Section: Periannular Extension Of Infectionmentioning

confidence: 99%

“…[301][302][303][304] Periannular infection is of even greater concern with PVE, occurring in 56% to 100% of patients. 298,302 Perivalvular abscesses are particularly common with prosthetic valves because the annulus, rather than the leaflet, is the usual primary site of infection, especially in early PVE and on bioprosthetic valves. 302 Under the influence of systemic intravascular pressures, abscesses may progress to fistulous tracts that create intracardiac or pericardial shunts.…”

Section: Periannular Extension Of Infectionmentioning

confidence: 99%

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Infective Endocarditis in Adults: Diagnosis, Antimicrobial Therapy, and Management of Complications

Baddour¹,

Wilson²,

Bayer³

et al. 2015

Circulation

2,540

1,421

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Background— Infective endocarditis is a potentially lethal disease that has undergone major changes in both host and pathogen. The epidemiology of infective endocarditis has become more complex with today’s myriad healthcare-associated factors that predispose to infection. Moreover, changes in pathogen prevalence, in particular a more common staphylococcal origin, have affected outcomes, which have not improved despite medical and surgical advances. Methods and Results— This statement updates the 2005 iteration, both of which were developed by the American Heart Association under the auspices of the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease of the Young. It includes an evidence-based system for diagnostic and treatment recommendations used by the American College of Cardiology and the American Heart Association for treatment recommendations. Conclusions— Infective endocarditis is a complex disease, and patients with this disease generally require management by a team of physicians and allied health providers with a variety of areas of expertise. The recommendations provided in this document are intended to assist in the management of this uncommon but potentially deadly infection. The clinical variability and complexity in infective endocarditis, however, dictate that these recommendations be used to support and not supplant decisions in individual patient management.

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Section: Periannular Extension Of Infectionmentioning

confidence: 99%

Section: Periannular Extension Of Infectionmentioning

confidence: 99%

Infective Endocarditis in Adults: Diagnosis, Antimicrobial Therapy, and Management of Complications

Baddour¹,

Wilson²,

Bayer³

et al. 2015

Circulation

2,540

1,421

View full text Add to dashboard Cite

show abstract

“…Persistent bacteremia or fever, recurrent emboli, heart block, CHF, or a new pathological murmur in a patient with IE on appropriate antibiotics may suggest extension. 242 Only aortic valve involvement and recent injection drug use have been prospectively identified as independent risk factors for perivalvular abscess. 236 On ECG, new atrioventricular block has a positive predictive value of 88% for abscess formation but low (45%) sensitivity.…”

Section: Periannular Extension Of Infectionmentioning

confidence: 99%

Infective Endocarditis

Baddour¹,

Wilson²,

Bayer³

et al. 2005

Circulation

1,277

436

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Background-Despite advances in medical, surgical, and critical care interventions, infective endocarditis remains a disease that is associated with considerable morbidity and mortality. The continuing evolution of antimicrobial resistance among common pathogens that cause infective endocarditis creates additional therapeutic issues for physicians to manage in this potentially life-threatening illness. Methods and Results-This work represents the third iteration of an infective endocarditis "treatment" document developed by the American Heart Association under the auspices of the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease of the Young. It updates recommendations for diagnosis, treatment, and management of complications of infective endocarditis. A multidisciplinary committee of experts drafted this document to assist physicians in the evolving care of patients with infective endocarditis in the new millennium. This extensive document is accompanied by an executive summary that covers the key points of the diagnosis, antimicrobial therapy, and management of infective endocarditis. For the first time, an evidence-based scoring system that is used by the American College of Cardiology and the American Heart Association was applied to treatment recommendations. Tables also have been included that provide input on the use of echocardiography during diagnosis and treatment of infective endocarditis, evaluation and treatment of culture-negative endocarditis, and short-term and long-term management of patients during and after completion of antimicrobial treatment. To assist physicians who care for children, pediatric dosing was added to each treatment regimen. Conclusions-The recommendations outlined in this update should assist physicians in all aspects of patient care in the diagnosis, medical and surgical treatment, and follow-up of infective endocarditis, as well as management of associated complications. Clinical variability and complexity in infective endocarditis, however, dictate that these guidelines be used to support and not supplant physician-directed decisions in individual patient management. (Circulation. 2005; 111:e394-e433.)

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“…Persistent bacteremia or fever, recurrent emboli, heart block, CHF, or a new pathological murmur in a patient with IE who is taking adequate antibiotics may suggest extension. 28,106 Only aortic-valve involvement and recent IVDA have been prospectively identified as independent risk factors for perivalvular abscess. 100 On ECG, new atrioventricular block has an 88% positive predictive value (number of true-positives divided by number of truepositives plus false-positives) for abscess formation but has a low sensitivity (45%).…”

Section: Periannular Extension Of Infectionmentioning

confidence: 99%