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Infeksiøs endokarditt

Sist oppdatert: Sist revidert:
Sist revidert av:
Definisjon:
Infeksjon av endokard, kronisk eller akutt forløp. Økt risiko ved kunstige hjerteklaffer, medfødte hjertefeil og hos sprøytenarkomane
Forekomst:
Insidens i området 3-10 per 100.000 pasientår, økende med alder
Symptomer:
Langvarig feber og uspesifikke symptomer som frysninger, nattesvette, slapphet og utilpasshet, anoreksi, vekttap, kvalme og oppkast
Funn:
Feber. Bilyd eller endret hjertetone. Nevrologiske utfall på grunn av cerebrale embolier. Vaskulittfenomener som skyldes perifere embolier: blødninger i negler, petekkier, Roths flekker (petekkier på retina)
Diagnostikk:
Forhøyet CRP. Blodkultur (+eventuelt PCR og serologisk undersøkelse) før behandling. Ekkokardiografi gir ofte diagnosen
Behandling:
Antibiotikabehandling nødvendig. Hjertekirurgi (klaffekirurgi) nødvendig hos så mange som 50% av pasientene

 

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  • Terje Johannessen, professor i allmennmedisin, Trondheim