Value of Transesophageal Echocardiography as an Adjunct to Transthoracic Echocardiography in Evaluation of Native and Prosthetic Valve Endocarditis (8)
In each of these patients, therapy was specifically and successfully directed to the underlying cause. In these patients with documented nonendocarditis bacterial infections (see Table 2), the appropriate course of antibiotics was administered, which in no case exceeded a 7- to 14-day course of antibiotics nor would it have been considered adequate therapy for the conventional treatment of endocarditis. After follow-up for three to six months, no patient has manifested evidence for infectious endocarditis or has received in the interim what would be considered adequate therapy for infectious endocarditis.
Table 2 also summarizes the various diagnoses resulting in symptoms leading up to suspected infectious endocarditis. Three patients had urosepsis, two had catheter-related infections and bacteremia (one Hickman catheter, one Perma-Cath, Quinton, Seattle), and two patients suffered from cellulitis overlying dialysis shunts. The remaining patients demonstrated various soft-tissue infectious or inflammatory processes as listed. Cheap Diskus Advair
Of the examinations in these 14 patients, one transthoracic examination was falsely abnormal and the remaining 13 were normal. The patient with a falsely abnormal transthoracic examination demonstrated asymmetric septal hypertrophy and an apparent chordal vegetation seen in association with the anterior leaflet of the mitral valve. By transesophageal echocardiogram, chordal thickening and systolic anterior motion were visualized giving the appearance of a highly mobile vegetation by transthoracic echocardiography.