Format

Send to

Choose Destination
J Am Coll Cardiol. 2016 Jan 19;67(2):151-158. doi: 10.1016/j.jacc.2015.10.065.

Systematic Search for Present and Potential Portals of Entry for Infective Endocarditis.

Author information

1
Department of Cardiology, Hôpital Louis Pradel, Hospices Civils de Lyon, Université Claude Bernard, Lyon, France. Electronic address: francois.delahaye@chu-lyon.fr.
2
Department of Cardiology, Hôpital Louis Pradel, Hospices Civils de Lyon, Lyon, France.
3
Department of Infectious Diseases, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France.
4
Centre National de Référence des Staphylocoques, Hospices Civils de Lyon, Lyon, France.

Abstract

BACKGROUND:

Looking for and treating the portal of entry (POE) of infective endocarditis (IE) is important, but published research on this topic is nonexistent.

OBJECTIVES:

The goal of this study was to systematically search for the POEs of present and potentially new episodes of IEs.

METHODS:

Patients were systematically seen by a stomatologist, an ear, nose, and throat specialist, and a urologist; women were systematically seen by a gynecologist; patients were seen by a dermatologist when there were cutaneous and/or mucous lesions. Colonoscopy and gastroscopy were performed if the microorganism came from the gastrointestinal tract in patients ≥50 years of age and in those with familial histories of colonic polyposis. Treatment of the POE was systematically considered.

RESULTS:

The POEs of the present IE episodes were identified in 74% of the 318 included patients. The most frequent POE was cutaneous (40% of identified POEs). It was mainly (62% of cutaneous POEs) associated with health care and with intravenous drug use. The second most frequent POE was oral or dental (29%). A dental infectious focus was more often involved (59% of oral or dental POEs) than a dental procedure (12%). POEs were gastrointestinal in 23% of patients. Colonic polyps were found in one-half of the patients and colorectal adenocarcinomas in 14%. Performance was good regarding the search for an oral or dental or a colonic potential POE, which were found in 53% and 40% of patients, respectively.

CONCLUSIONS:

Our search for the POEs of present IEs was often successful, as was searching for an oral or dental or a gastrointestinal POE of a new IE episode. We advise the systematic performance of stomatologic examinations in patients with IE and performance of colonoscopy in patients ≥50 years of age or at high risk for colorectal cancer.

KEYWORDS:

colonic abnormalities; cutaneous infections; dental infections

PMID:
26791061
DOI:
10.1016/j.jacc.2015.10.065
[Indexed for MEDLINE]
Free full text

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center