Endocarditis in burn patients: Clinical and diagnostic considerations

摘要: Abstract Background Burned patients are at high risk for invasive procedures, bacteremia, and other infectious complications. Previous publications describe incidence, delayed diagnosis, mortality endocarditis in burned patients, but do not address use of contemporary diagnostic criteria. Further analysis the clinical presentation diagnosis may aid earlier recognition decreased patients. Methods At a 40 bed burn center, during period from 1 January 2003 to August 2006, blood culture, electronic inpatient, echocardiographic, autopsy records were reviewed cases persistent bacteremia (blood culture positivity same organism separated by 24 h). In addition, we burn-related bacterial published English language. We compared aspects our identified with those literature. Results There 90 episodes or fungemia 56 1250 admitted study period. Echocardiography was performed on 19, identifying 4 endocarditis. One additional case post-mortem. Time until echocardiography ranged 6 176 days after onset bacteremia. Case patient age 31 64 years, total surface area 34 80%. Endocarditis occurred 0.4% unit admissions 8.9% these Sites involved included mitral valve (3), tricuspid (2), aortic (1), pulmonic (1). Pathogens Staphylococcus aureus , Pseudomonas aeruginosa one Enterococcus faecium . Diagnostic clues minimal. 100%. A literature review revealed 17 describing confirmed These predilection infection S. P. relative paucity prior death, trend towards ante-mortem increased survival echocardiography. Conclusions The incidence remain high. Clinical this cohort minimal be delayed. For especially unknown source, should entertained early considered.