Document Detail


Incidence of neurological complications in patients with native-valve infective endocarditis and cerebral microembolism: an open cohort study.
MedLine Citation:
PMID:  19685379     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The objective of this open cohort study was to assess the association between neurological complications in patients with definite native-valve infective endocarditis (IE) and cerebral microembolism (MES). MES detection was performed with 1-h, bilateral middle cerebral arteries (MCA) insonation using a transcranial Doppler ultrasound (TCD) machine. Thirty patients with definite native-valve IE were stratified into 2 groups based upon the presence of MES. The most striking difference between the 2 groups of patients was the incidence of clinically evident neurological complications. Neurological complications of IE occurred in 10 (83.3%) patients with positive MES and in 6 (33.3%) MES-negative patients (p=0.021). Ischaemic stroke was the most common complication, occurring in 11 of 16 patients, followed by meningitis in 4 patients and cerebritis in 1 patient. There was a trend towards greater in-hospital mortality in patients with recorded MES than in the MES-negative, although this was not statistically significant (33.3% vs 16.6%; p=0.392). Our results reveal a significant association between MES and neurological complications in patients with native-valve IE. TCD is a promising tool in predicting individual patient risk for neurological complications of IE.
Authors:
Dragan Lepur; Bruno Barsi?
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Scandinavian journal of infectious diseases     Volume:  41     ISSN:  1651-1980     ISO Abbreviation:  Scand. J. Infect. Dis.     Publication Date:  2009  
Date Detail:
Created Date:  2009-12-17     Completed Date:  2010-03-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0215333     Medline TA:  Scand J Infect Dis     Country:  England    
Other Details:
Languages:  eng     Pagination:  708-13     Citation Subset:  IM    
Affiliation:
Department of Neuroinfections and Intensive Care Medicine, University Hospital for Infectious Diseases Dr. Fran Mihaljevi?, Zagreb, Croatia. lepurix@inet.hr
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Brain Abscess / etiology,  ultrasonography
Brain Ischemia / etiology,  ultrasonography
Cerebral Hemorrhage / etiology,  ultrasonography
Chi-Square Distribution
Cohort Studies
Endocarditis / complications*,  ultrasonography
Female
Humans
Intracranial Embolism / complications*,  ultrasonography
Male
Meningitis / etiology,  ultrasonography
Middle Aged
Nervous System Diseases / etiology*,  ultrasonography
Prospective Studies
Ultrasonography, Doppler, Transcranial

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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