Tuesday, February 17, 2009

Musculoskeletal symptoms in first-episode of infective endocarditis

Infective endocarditis (IE) is a cardiac endocardial surface microbial infections, the typical lesions associated with neoplasm formation, most of heart valve damage. The past 30 years, as a result of intravenous drug abuse, involvement in examination and treatment operations, as well as the wider use of antibiotics, IE does not reduce the incidence of clinical performance has changed, become more diversified.

IE from bacteria, fungi and other microbial infection caused by endocardial easily involved heart valve, and its characteristic vegetation formation of pathological damage. Many occurred in the original film valvular heart disease, congenital cardiovascular malformations or artificial valve replacement, but may also occur in the normal heart valves on. According to course and can be divided into acute and subacute; by valve type, can be divided into autologous valve endocarditis (NVE) and prosthetic valve endocarditis (PVE); by pathogens, can be divided into bacterial, fungal, Chlamydia and Rickettsia, the viral and so on; by the involvement of the right heart valves can be divided into IE, the left heart valve IE.

In recent years the average life expectancy as a result of population, IE the clinical point of major changes. Incidence of age from young people tend to the elderly, the proportion of high-risk patients constitute a significant change in hospital-acquired infection, long-term by the hemodialysis vascular access line, and senile degenerative heart valve patients, intravenous drug addicts, as well as home artificial devices into the heart to the ratio of the notable increase in the number of IE susceptible.

Some scholars have noted in the 1970 joint muscles in the importance of IE, has been reported since then, the patient can be manifested as joint pain, neck pain, back pain, myalgia, etc. The incidence of 25% -45%, with 27% of patients with these symptoms may be the first.

IE is not a clinical incurable diseases, but a small number of cases there is no typical clinical features, together with the onset of occult easily misdiagnosed. Especially in patients with non-cardiac medical specialist, the specialist has a certain degree of thinking, easy to establish the diagnosis based solely on symptoms and ignore the IE. If the joints, muscles in patients with lesions in the course of treatment efficacy or poor can not explain the situation, should take into account the possibility of IE is not typical for the relevant inspection, confirmed as soon as possible.

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