Thursday, December 4, 2008

Endocarditis again

Again IE....
Now, on NEJM a case of IE in MVP.....Just sent for me as pre-release article.
the main aim of the case report was the judgment should rely on clinical sense first before criteria.

NEJM: (In conclusion, attention to the context of a patient's clinical presentation, particularly in considering diseases with protean or nonspecific manifestations, is essential for prompt, accurate diagnosis and appropriate treatment. The use of diagnostic criteria should be guided by the clinical context, as well as consideration of other conditions with similar manifestations and possible limitations of the criteria themselves. )

I had manged many cases of IE upon clinical sense and did not wait for fullfilling all cretireia to diagnose. one male patient aged 19 yesr old with history of FUO. H e was reffered after exclusion of tropical causes of fever which were first in DD List. echocardiography reaveled vegetations over the AO valve. TTE was superior in Ao valve imaging than TEE . so, we started mangment. this patient did not fullfill the criteris. But, we relied on our clinical sense. I should put separate article on this patient once I archieve all my data of cases.
Shall I remind again with the post of :
Of note, I will add a poll regarding the new guidelines of prophylaxis against IE.

I power

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