Endocarditis laboratory findings: Difference between revisions
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==Renal Function== | ==Renal Function== | ||
The serum [[BUN]] and [[Cr]] may be elevated if [[glomerulonephritis]] is present. | The serum [[BUN]] and [[Cr]] may be elevated if [[glomerulonephritis]] is present. | ||
==2008 ACC/AHA Guidelines for the Management of Patients with Valvular Heart Disease - Evaluation of Infective Endocarditis (DO NOT EDIT)<ref name="pmid18820172">{{cite journal |author=Bonow RO, Carabello BA, Chatterjee K, ''et al.'' |title=2008 Focused update incorporated into the ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease): endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons |journal=Circulation |volume=118 |issue=15 |pages=e523–661 |year=2008 |month=October |pmid=18820172 |doi=10.1161/CIRCULATIONAHA.108.190748 |url=}}</ref>== | |||
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| colspan="1" style="text-align:center; background:LightGreen"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class I]] | |||
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| bgcolor="LightGreen"|<nowiki>"</nowiki>'''1.''' Patients at risk for [[infective endocarditis]] who have unexplained [[fever]] for more than 48 h should have at least 2 sets of blood cultures obtained from different sites. ([[ACC AHA guidelines classification scheme#Level of Evidence|Level B]])<nowiki>"</nowiki> | |||
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| colspan="1" style="text-align:center; background:LightCoral"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class III]] | |||
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| bgcolor="LightCoral"|<nowiki>"</nowiki>'''1.''' Patients with known [[valvular disease]] or a [[Artificial heart valve|valve prosthesis]] should not receive [[antibiotics]] before blood cultures are obtained for unexplained [[fever]]. ([[ACC AHA guidelines classification scheme#Level of Evidence|Level B]])<nowiki>"</nowiki> | |||
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===Urinalysis=== | ===Urinalysis=== | ||
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A CT scan of the head should be obtained in patients who exhibit CNS symptoms or findings consistent with a mass effect (eg, macroabscess of the brain). | A CT scan of the head should be obtained in patients who exhibit CNS symptoms or findings consistent with a mass effect (eg, macroabscess of the brain). | ||
=== | ==Sources== | ||
*2008 ACC/AHA Guidelines incorporated into the 2006 guidelines for the management of patients with valvular heart disease <ref name="pmid18820172">{{cite journal |author=Bonow RO, Carabello BA, Chatterjee K, ''et al.'' |title=2008 Focused update incorporated into the ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease): endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons |journal=Circulation |volume=118 |issue=15 |pages=e523–661 |year=2008 |month=October |pmid=18820172 |doi=10.1161/CIRCULATIONAHA.108.190748 |url=}}</ref> | |||
==References== | ==References== | ||
Revision as of 19:31, 29 October 2012
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Endocarditis Microchapters |
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Diagnosis |
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Treatment |
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2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease |
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Case Studies |
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Endocarditis laboratory findings On the Web |
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Risk calculators and risk factors for Endocarditis laboratory findings |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editors-in-Chief: Cafer Zorkun, M.D., Ph.D. [2]
Overivew
In endocarditis, the white blood cell count and erythrocyte sedimentation rate are elevated. The rheumatoid factor is elevated in half of patients. The BUN and Cr may be elevated in the presence of glomerulonephritis. The EKG can show conduction abnormalities in the presence of a myocardial abscess. The EKG can show ST elevation in the presence of embolization of a vegetation or clot down the coronary artery.
Leukocytosis
A marked leukocytosis is present.
Erythrocyte Sedimentation Rate
An elevated erythrocyte sedimentation rate is present.
Rheumatoid Factor
A positive serum rheumatoid factor may be present and is present in approximately 50% of patients with subacute disease. It becomes negative after successful treatment.
Renal Function
The serum BUN and Cr may be elevated if glomerulonephritis is present.
2008 ACC/AHA Guidelines for the Management of Patients with Valvular Heart Disease - Evaluation of Infective Endocarditis (DO NOT EDIT)[1]
| Class I |
| "1. Patients at risk for infective endocarditis who have unexplained fever for more than 48 h should have at least 2 sets of blood cultures obtained from different sites. (Level B)" |
| Class III |
| "1. Patients with known valvular disease or a valve prosthesis should not receive antibiotics before blood cultures are obtained for unexplained fever. (Level B)" |
Urinalysis
Glomerulonephritis may be present.
Electrocardiogram
There is no specific EKG changes that are diagnostic of Infective Endocarditis. The EKG may be useful in the detection of the 10% of patients who develop a conduction delay during Infective Endocarditis by documenting an increased PR interval. If myocardial infarction is present, it may be due to vessel occlusion with ST elevation myocardial infarction or it may be due to distal embolism which may result in non ST elevation MI.
Chest X Ray
There are no specific chest x-ray findings specific for the diagnosis of endocarditis. Non specific findings would include findings of congestive heart failure.
MRI and CT
A CT scan of the head should be obtained in patients who exhibit CNS symptoms or findings consistent with a mass effect (eg, macroabscess of the brain).
Sources
- 2008 ACC/AHA Guidelines incorporated into the 2006 guidelines for the management of patients with valvular heart disease [1]
References
- ↑ 1.0 1.1 Bonow RO, Carabello BA, Chatterjee K; et al. (2008). "2008 Focused update incorporated into the ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease): endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons". Circulation. 118 (15): e523–661. doi:10.1161/CIRCULATIONAHA.108.190748. PMID 18820172. Unknown parameter
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