Das klinische Bild der infektiösen Endokarditis

  • K. Gahl
  • A. Mügge
  • B. Nonnast-Daniel
Chapter

Zusammenfassung

Das klinische Bild der infektiösen Endokarditis stellt den Arzt vor zahlreiche Probleme. Es gilt, aus einem wechselnden Muster von teils unspezifischen, teils organweisenden Beschwerden, klinischen Zeichen und labormedizinischen Befunden den Verdacht auf die kardiale Erkrankung zu schöpfen und ihn zu erhärten durch eine gezielt weiterführende Diagnostik. Infektionsmodus und Erreger, konditionierende Faktoren auf seiten des Kranken und Behandlungsmaßnahmen prägen die chamäleonartige Vielgestaltigkeit des Krankheitsbildes in seiner Primärmanifestation wie auch im weiteren Verlauf, der durch kardiale und extrakardiale Prozesse oder Komplikationen bestimmt wird. Die pathogenetischen Mechanismen der Erkrankung wie Erregeradhärenz am Endokard, immunologische Prozesse und extrakardiale Manifestation sind noch immer nicht hinreichend geklärt. Schließlich bietet die Krankheit auch therapeutische Probleme bezüglich der antibiotischen und “adjuvanter” Therapie.

This is a preview of subscription content, log in to check access.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Literatur

  1. Abelmann WH (1979): Infective carditis: The clinical syndromes and the changing spectrum. Exc Med Internat Congr Ser 470:531–535Google Scholar
  2. Alpert JS, Krous HF, Dalen JE, O’Rourke RA & Bloor CM (1976): Pathogenesis of Osier’s nodes. Ann Intern Med 85:471–473PubMedCrossRefGoogle Scholar
  3. Anschütz F (1968): Klinik der Endokarditis. In: Anschütz F (Hg.): Endokarditis — Klinik, Ätiologie, Pathogenese, Pathologie, Therapie. Thieme-Verlag, Stuttgart, S. 1–103Google Scholar
  4. Applefeld MM & Hornick RB (1974): Infective endocarditis in patients over age 60. Amer Heart J 88:90–94PubMedCrossRefGoogle Scholar
  5. Arnett EN & Roberts WC (1976): Valve ring abscess in active infective endocarditis. Frequency, location, and clues to clinical diagnosis from the study of 95 necropsy patients. Circul 54:140–145CrossRefGoogle Scholar
  6. Bademosi O, Falase AO, Jaiyesimi F & Rademosi A (1976): Neuropsychiatric manifestations of infective endocarditis: A study of 95 patients at Ibadan, Nigeria. J Neurol Neurosurg & Psych 39:325–329CrossRefGoogle Scholar
  7. Bayer AS, Brenner RJ, Galpin JE & Guze LB (1975): Severe disabling polyarthritis associated with bacterial endocarditis. West J Med 123:404–406PubMedGoogle Scholar
  8. Bayer AS, Theofilopoulos AN, Eisenberg R, Frieman SG & Guze LB (1977): Thrombotic thrombocytopenic pupuralike syndrome associated with infective endocarditis — A possible immune complex disorder. J Amer Med Assoc 238:408–410CrossRefGoogle Scholar
  9. Blumenthal J, Wolfson PM, Haspel L & Dunlap S (1977): Infective endocarditis: A current view. J AO Assoc 76:576/49–584/57Google Scholar
  10. Bohmfalk GL, Story JL, Wissinger JP & Brown WE (1978): Bacterial intracranial aneurysm. J Neurosurg 48:369–382PubMedCrossRefGoogle Scholar
  11. Buchbinder NA & Roberts WC (1972): Active infective endocarditis confined to mural endocardium. A study of six necropsy patients. Arch Pathol 93:435–440PubMedGoogle Scholar
  12. Buchbinder NA & Roberts WC (1973): Alcoholism: An important but unemphasized factor predisposing to infective endocarditis. Arch Intern Med 132:689–692PubMedCrossRefGoogle Scholar
  13. Burnside JW & DeSanctis RW (1972): Bacterial endocarditis on calcification of the mitral annulus fibrosus. Annals Int Med 76:615–618CrossRefGoogle Scholar
  14. Cannon NJ & Cobbs CG (1976): Infective endocarditis in drug addicts. In: Kaye D. (ed.): Infective Endocarditis. University Park Press, Baltimore, London, Tokyo, pp 87–100Google Scholar
  15. Cates JE & Christie RV (1951): Subacute Bacterial endocarditis — A review of 442 patients treated in 14 centres appointed by the Penicillin Trials Committee of the Medical Research Council. Quart J Med, New Series 20:93–130Google Scholar
  16. Chase RM (1973): Infective endocarditis today. Med Clin North Amer 57:1383–1393Google Scholar
  17. Cherubin CE & Neu HC (1971): Infective endocarditis at the Presbyterian Hospital in New York City from 1938–1967. Amer J Med 51:83–96PubMedCrossRefGoogle Scholar
  18. Chesler E, Korns ME, Porter GE, Reyes CN & Edwards JE (1968): False aneurysm of the left ventricle secondary to bacterial endocarditis with perforation of the mitral-aortic intervalvular fibrosa. Circul 37:518–523CrossRefGoogle Scholar
  19. Chestier Y, Duval A, Luxereau P (1978): Acquired ventricular septal defects during bacterial endocarditis. A case report with a review of the literature. Arch Mal Coeur Vaiss 71:23–32Google Scholar
  20. Chomette G, Brocherion C, Delcourt A & Agebo M (1976): Les endocardites suppurées pariétales. Ann Med Interne 127:83–89Google Scholar
  21. Churchill MA, Geraci JE & Hunder GG (1977): Musculosceletal manifestations of bacterial endocarditis. Ann Int Med 87:754–759PubMedCrossRefGoogle Scholar
  22. Cooper ES, Cooper JW & Schnabel TG (1966): Pitfalls in the diagnosis of bacterial endocarditis. Arch Int Med 118:55–61CrossRefGoogle Scholar
  23. Copeland JG, Salomon NW, Stinson EB, Popp RL & Shumway NE (1979): Acute mitral valvular obstruction from infective endocarditis. J Thorac Cardiovasc Surg 78:128–130PubMedGoogle Scholar
  24. DeCock KM & Rees JR (1978): Staphylococcal aortic valve endocarditis with aortic root to right atrial fistula. Postgrad Med J 54:413CrossRefGoogle Scholar
  25. Dryer R, Goldman D & Nelson R (1976): Septic thrombophlebitis of the coronary sinus in acute bacterial endocarditis. Lancet 2:369PubMedCrossRefGoogle Scholar
  26. Eichstädt H, Maisch B, Wessely B & Kochsiek K (1979): Untersuchungen zum Formenwandel der infektiösen Endokarditis. Med Welt 30:727–730PubMedGoogle Scholar
  27. Ellner JJ, Rosenthal MS, Lerner PI & McHenry MC (1979): Infective endocarditis caused by slow-growing, fastidious, gram-negative bacteria. Medicine 58:145–158PubMedCrossRefGoogle Scholar
  28. Everett ED & Hirschmann JV (1977): Transient bacteremia and endocarditis prophylaxis: A review. Medicine 56:61–77PubMedGoogle Scholar
  29. Freedman LR (1982): Infective Endocarditis and other Intravascular Infections. Plenum Medical Book Comp, New York, LondonCrossRefGoogle Scholar
  30. Garvey GJ & Neu HC (1978): Infective endocarditis — An evolving disease. A review of endocarditis at the Columbia Presbyterian Medical Centre 1968–1973. Medicine 57:105–127PubMedCrossRefGoogle Scholar
  31. Good AE, Hague JM & Kauffman CA (1978): Streptococcal endocarditis initially seen as septic arthritis. Arch Int Med 138:805–806CrossRefGoogle Scholar
  32. Greenlee JE & Mandell GL (1973): Neurological manifestations of infective endocarditis: A review. Stroke 4:958–963PubMedCrossRefGoogle Scholar
  33. Härkönen M, Olin PE & Wennström J (1981): Severe backache as a presenting sign of bacterial endocarditis. Acta Med Scand 210:329–331PubMedCrossRefGoogle Scholar
  34. Harvey WP & Capone MA (1961): Bacterial endocarditis related to cleaning and filling of teeth. Amer J Cardiol 7:793–798PubMedCrossRefGoogle Scholar
  35. Hermans PE (1982): The clinical manifestations of infective endocarditis. Mayo Clin Proc 57:15–21PubMedGoogle Scholar
  36. Johnson JD, Raff MJ, Barnwell PA & Chun CH (1983): Splenic abscess complicating infectious endocarditis. Arch Intern Med 143:906–912PubMedCrossRefGoogle Scholar
  37. Johnson WD (1976): The clinical syndrome. In: Kaye D. (ed.): Infective Endocarditis. University Park Press, Baltimore, London, Tokyo, pp 87–100Google Scholar
  38. Jones HR, Siekert RG & Geraci JE (1969): Neurologic manifestations of bacterial endocarditis. Ann Intern Med 71:21–28PubMedCrossRefGoogle Scholar
  39. Kaye D (1973): Changes in the spectrum, diagnosis and management of bacterial and fungal endocarditis. Med Clin North Amer 57:941–957Google Scholar
  40. Kerr A (1955): Subacute Bacterial Endocarditis. Thomas, Springfield/Ill.Google Scholar
  41. Kilpatrick ZM, Greenberg PA & Sanford JP (1965): Splinter hemorrhages — their clinical significance. Arch Int Med 115:730–735CrossRefGoogle Scholar
  42. Kim HS, Weibaecher DG & Lie JT (1976): Myocardial abscesse without and with coexisting infectious endocarditis. Circul 55:11–21Google Scholar
  43. Kim HS, Weilbaecher DG, Lie JT & Titus JL (1978): Myocardial abscesses. Amer J Clin Pathol 70:18–23Google Scholar
  44. Koenig MG (1969): Diagnosis of bacterial endocarditis. Hosp Med, June, 80–88Google Scholar
  45. Kyburz P, Raeder EA & Burckhardt D (1978): Klinische Aspekte der infektiösen Endokarditis. Schweiz Rundschau Med (Praxis) 67:231–236Google Scholar
  46. LeFrock JL & Klainer AS (1975): Bacterial endocarditis. West Virg Med J 71:1–7Google Scholar
  47. Lerner PJ & Weinstein L (1966): Infective endocarditis in the antibiotic era (4 parts): New Engl J Med 274:199–206PubMedCrossRefGoogle Scholar
  48. Lerner PJ & Weinstein L (1966): Infective endocarditis in the antibiotic era (4 parts): New Engl J Med 274:259–266PubMedCrossRefGoogle Scholar
  49. Lerner PJ & Weinstein L (1966): Infective endocarditis in the antibiotic era (4 parts): New Engl J Med 274:323–331CrossRefGoogle Scholar
  50. Lerner PJ & Weinstein L (1966): Infective endocarditis in the antibiotic era (4 parts): New Engl J Med 274:388–393PubMedCrossRefGoogle Scholar
  51. Libman E & Friedberg CK (1947): Subacute Bacterial Endocarditis. Oxford University Press, New YorkGoogle Scholar
  52. Lode H, Harnoss CM, Wagner J, Biamino G & Schröder R (1982): Infektive Endokarditis. Klinik, Therapie und Verlauf bei 103 Erkrankungen. Dtsch Med Wschr 107:967–974PubMedCrossRefGoogle Scholar
  53. Lowenstein MB, Urmann JD, Abeles M & Weinstein A (1977): Skin immunofluorescence in infective endocarditis. J Amer Med Assoc 238:1163–1165CrossRefGoogle Scholar
  54. Martini GA & Seitz R (1981): Bakterielle Endokarditis bei chronischem Alkoholmißbrauch und alkoholtoxischer Leberschädigung. Ein Beitrag zur Pathologie des Alkohols. Dtsch Med Wschr 106:1173–1176PubMedCrossRefGoogle Scholar
  55. McAnulty JH, Rahimtoola SH, DeMots H & Griswold HE (1978): Clinical features of infective endocarditis. In: Rahimtoola SH (ed.): Infective Endocarditis. Grune & Stratton, New York, San Francisco, London, pp 125–148Google Scholar
  56. Mehta AP, Dave KM & Kinare SG (1978): Infective endocarditis — A survey of the past 50 years. J Postgrad Med 24:40–49PubMedGoogle Scholar
  57. Mildvan D, Goldberg E, Berger M, Altchek MR & Lukban SB (1977): Diagnosis and successful management of septal myocardial abscess: A complication of bacterial endocarditis. Amer J Med Sci 274:311–316PubMedCrossRefGoogle Scholar
  58. Mills J, Utley J & Abbott J (1974): Heart failure in infective endocarditis: Predisposing factors, course, and treatment. Chest 66:151–157PubMedCrossRefGoogle Scholar
  59. Milstoc M & Berger AR (1971): True bacterial mural endocarditis. Chest 59:103–105PubMedCrossRefGoogle Scholar
  60. Mostaghim D & Millard HD (1975): Bacterial endocarditis: A retrospective study. Oral Surgery 40:219–234CrossRefGoogle Scholar
  61. Nager F (1982): Infektiöse Endokarditis — eine sich wandelnde Krankheit. Schweiz Rundschau Med (Praxis) 71:1917–1921Google Scholar
  62. Nager F, Pfisterer M, Rothlin M & Kappenberger L (1975): Epidemiologie und Klinik der infektiösen Endokarditis. Schweiz Med Wschr 105:1421–1427PubMedGoogle Scholar
  63. Pankey GA (1961): Subacute bacterial endocarditis at the University of Minnesota Hospital, 1939–1959. Ann Int Med 55:550–561PubMedCrossRefGoogle Scholar
  64. Pankey GA (1962): Acute bacterial endocarditis at the University of Minnesota Hospital, 1939–1959. Amer Heart J 64:583–591CrossRefGoogle Scholar
  65. Pankey GA (1979): The prevention and treatment of bacterial endocarditis. Amer Heart J 98:102–118PubMedCrossRefGoogle Scholar
  66. Pease HF, Matsumoto S, Cacchione RJ, Richards KL & Leach JK (1978): Lethal obstruction by aortic valvular vegetation. Echocardiographic studies of endocarditis without apparent aortic regurgitation. Chest 73:658–660PubMedCrossRefGoogle Scholar
  67. Pelletier LL & Petersdorf RG (1977): Infective endocarditis: A review of 125 cases from the University of Washington Hospitals, 1963–1972. Medicine 56:287–313PubMedCrossRefGoogle Scholar
  68. Persaud V (1970): Two unusual cases of mural endocarditis, with a review of the literature. Amer J Clin Pathol 53:832–838Google Scholar
  69. Prasquier R, Gibert C, Witchitz S, Valere P, Beaufils P & Vachon F (1978): Acute mitral valve obstruction during infective endocarditis. Brit Med J 1:9–11PubMedCrossRefGoogle Scholar
  70. Pruitt AA, Rubin RH, Karchmer AW & Duncan GW (1978): Neurologic complications of bacterial endocarditis. Medivine 57:329–343Google Scholar
  71. Rau G (1972): Infektiöse Endokarditis. Therapiewoche 22:1092–1104Google Scholar
  72. Reed WP & Williams RC (1977): Immune complexes in infectious disease. Adv Intern Med 22:49–72PubMedGoogle Scholar
  73. Reeve R, Reeve JS, Matula G & Lawson W (1974): Mitral obstruction by vegetations of staphylococcal endocarditis. J Amer Med Assoc 228:75CrossRefGoogle Scholar
  74. Ries K (1976): Endocarditis in the elderly. In: Kaye D (ed.): Infective Endocarditis. University Park Press, Baltimore, London, Tokyo, pp 143–154Google Scholar
  75. Roberts WC (1978): Characteristics and consequences of infective endocarditis (active or healed or both) learned from morphologic studies. In: Rahimtoola SH (ed.): Infective Endocarditis. Grune & Stratton, New York, San Francisco, London, pp 55–123Google Scholar
  76. Roberts WC, Ewy GA, Glancy DL & Marcus FJ (1967): Valvular stenosis produced by active infective endocarditis. Circul 36:449CrossRefGoogle Scholar
  77. Rose RL, Higgins LS & Helgason AH (1967): Bacterial endocarditis, pericarditis and cardiac tamponade. Amer J Cardiol 19:447–451PubMedCrossRefGoogle Scholar
  78. Sacks PV, Lakier JB & Barlow JB (1969): Severe aortic stenosis produced by bacterial endocarditis. Brit Med J 3:97PubMedCrossRefGoogle Scholar
  79. Schaub F (1960): Klinik der subakuten bakteriellen Endokarditis. Springer-Verlag BerlinCrossRefGoogle Scholar
  80. Scheid WM & Sande ME (1979): Endocarditis and intravascular infections. In: Mandell GI, Douglas RG, Bennett JE (eds.): Principles and Practice of Infectious Diseases. John Wiley & Sons New York, pp 653–690Google Scholar
  81. Schölmerich P (1960): Erkrankungen des Endokards — Bakterielle Endokarditis. In: Schwiegk H (Hg.): Handbuch der Inneren Medizin, Bd. IX/II. Springer-Verlag, Berlin, Göttingen, Heidelberg, S. 662–771Google Scholar
  82. Schnurr LP, Ball AP, Geddes AM, Gray J & McGhie D (1977): Bacterial endocarditis in England in the 1970’s: A review of 70 patients. Quart J Med, New Series 46:499–512Google Scholar
  83. Siekert RG & Jones R (1970): Transient cerebral ischemic attacks associated with subacute bacterial endocarditis. Stroke 1:178–183PubMedCrossRefGoogle Scholar
  84. Smith FE & Palmer DL (1976): Alcoholism, infection and altered host defenses: A review of clinical and experimental observations. J Chron Dis 29:35–49PubMedCrossRefGoogle Scholar
  85. Starkebaum M, Durack D & Beeson P (1977): The “incubation period” of subacute bacterial endocarditis. Yale J Biol & Med 50:49–58Google Scholar
  86. Stimmel B & Dack S (1978): Infective endocarditis in narcotic addicts. In: Rahimtoola SH (ed.): Infective Endocarditis. Grune & Stratton, New York, San Francisco, London, pp 195–209Google Scholar
  87. Thornton JB & Alves JC (1981): Bacterial endocarditis. A retrospective study of cases admitted to the University of Alabama Hospitals from 1969 to 1979. Oral Surg 52:379–383PubMedCrossRefGoogle Scholar
  88. Watanakunakorn C (1977): Changing epidemiology and newer aspects of infective endocarditis. Adv Int Med 22:21–47Google Scholar
  89. Weinstein L (1980): Infective endocarditis. In: Braunwald E (ed.): Heart Disease. Saunders, Philadelphia, London, Toronto, pp 1166–1220Google Scholar
  90. Weinstein L & Rubin RH (1973): Infective endocarditis — 1973. Progr Cardiovasc Dis 16:239–274CrossRefGoogle Scholar
  91. Weinstein L & Schlesinger JJ (1973): Treatment of infective endocarditis — 1973. Progr Cardiovasc Dis 16:275–302CrossRefGoogle Scholar
  92. Weinstein L & Schlesinger JJ (1974): Pathoanatomic, pathophysiologic, and clinical correlations in endocarditis (2 parts). New Engl J Med 291:832–837PubMedCrossRefGoogle Scholar
  93. Weinstein L & Schlesinger JJ (1974): Pathoanatomic, pathophysiologic, and clinical correlations in endocarditis (2 parts). New Engl J Med 291:1122–1126PubMedCrossRefGoogle Scholar
  94. Wennevold A, Rygg IH & Jacobsen JR (1976): Acute aortic regurgitation and abscess of sinus of Valsalva due to fulminating ulcerative endocarditis — Report of three cases in children. Scand J Thorac Cardiovasc Surg 10:7–10PubMedCrossRefGoogle Scholar
  95. Ziment I (1969): Nervous system complications in bacterial endocarditis. Amer J Med 47:593–607PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1984

Authors and Affiliations

  • K. Gahl
  • A. Mügge
  • B. Nonnast-Daniel

There are no affiliations available

Personalised recommendations