guias endocarditis 2015
TRANSCRIPT
![Page 1: Guias endocarditis 2015](https://reader038.vdocuments.mx/reader038/viewer/2022110108/587303511a28ab99088b4c1b/html5/thumbnails/1.jpg)
2015 ESC Guidelines for the management of infective endocarditis
THE TASK FORCE FOR THE MANAGEMENT OF INFECTIVE ENDOCARDITIS OF THE EUROPEAN SOCIETY OF CARDIOLOGY (ESC)
DR. ANDRES OLARTE. RESIDENTE MEDICINA INTERNA FOSCAL-UNAB
![Page 2: Guias endocarditis 2015](https://reader038.vdocuments.mx/reader038/viewer/2022110108/587303511a28ab99088b4c1b/html5/thumbnails/2.jpg)
![Page 3: Guias endocarditis 2015](https://reader038.vdocuments.mx/reader038/viewer/2022110108/587303511a28ab99088b4c1b/html5/thumbnails/3.jpg)
Endocarditis Infecciosa
Se define cómo infeccción de la superficie endocardica del corazón, la cúal puede incluir una o más valvulas cardiacas, o un defecto septal.
Los casos de endocarditis no infecciosa, debida a drogas EV y endocarditis de valvula protesica se han incrmentado considerablemente.
Las infecciones valvulares pueden ser causadas secundario al aumento de la realización de procedimientos intravasculares.
![Page 4: Guias endocarditis 2015](https://reader038.vdocuments.mx/reader038/viewer/2022110108/587303511a28ab99088b4c1b/html5/thumbnails/4.jpg)
Definiciones
![Page 5: Guias endocarditis 2015](https://reader038.vdocuments.mx/reader038/viewer/2022110108/587303511a28ab99088b4c1b/html5/thumbnails/5.jpg)
![Page 6: Guias endocarditis 2015](https://reader038.vdocuments.mx/reader038/viewer/2022110108/587303511a28ab99088b4c1b/html5/thumbnails/6.jpg)
Profilaxis
![Page 7: Guias endocarditis 2015](https://reader038.vdocuments.mx/reader038/viewer/2022110108/587303511a28ab99088b4c1b/html5/thumbnails/7.jpg)
Pacientes que requieren profilaxis antibiotica:
![Page 8: Guias endocarditis 2015](https://reader038.vdocuments.mx/reader038/viewer/2022110108/587303511a28ab99088b4c1b/html5/thumbnails/8.jpg)
Medidas de prevención no especificas en pacientes de riesgo intermedio-alto.
![Page 9: Guias endocarditis 2015](https://reader038.vdocuments.mx/reader038/viewer/2022110108/587303511a28ab99088b4c1b/html5/thumbnails/9.jpg)
Procedimintos que requieren profilaxis antibiotica
![Page 10: Guias endocarditis 2015](https://reader038.vdocuments.mx/reader038/viewer/2022110108/587303511a28ab99088b4c1b/html5/thumbnails/10.jpg)
Procedimintos que requieren profilaxis antibiotica
![Page 11: Guias endocarditis 2015](https://reader038.vdocuments.mx/reader038/viewer/2022110108/587303511a28ab99088b4c1b/html5/thumbnails/11.jpg)
Profilaxis recomenada en pacientes de alto riesgo y procedimientos de alto riesgo.
![Page 12: Guias endocarditis 2015](https://reader038.vdocuments.mx/reader038/viewer/2022110108/587303511a28ab99088b4c1b/html5/thumbnails/12.jpg)
Recomendaciones para procedimiento vasculares y valvulares
![Page 13: Guias endocarditis 2015](https://reader038.vdocuments.mx/reader038/viewer/2022110108/587303511a28ab99088b4c1b/html5/thumbnails/13.jpg)
ECOCARDIOGRAFIA EN EL DIAGNÓSTICO
![Page 14: Guias endocarditis 2015](https://reader038.vdocuments.mx/reader038/viewer/2022110108/587303511a28ab99088b4c1b/html5/thumbnails/14.jpg)
Uso del ECOTT y ECOTE
Seguimiento durante el tratamiento
Intraoperatorio durante cirugía cardiaca
Posterior al fin de la terapia
![Page 15: Guias endocarditis 2015](https://reader038.vdocuments.mx/reader038/viewer/2022110108/587303511a28ab99088b4c1b/html5/thumbnails/15.jpg)
Indicaciones de ecocardiografía en E.I.
![Page 16: Guias endocarditis 2015](https://reader038.vdocuments.mx/reader038/viewer/2022110108/587303511a28ab99088b4c1b/html5/thumbnails/16.jpg)
Organismos etiológicos
![Page 17: Guias endocarditis 2015](https://reader038.vdocuments.mx/reader038/viewer/2022110108/587303511a28ab99088b4c1b/html5/thumbnails/17.jpg)
Agentes etiológicos
•Streptococci: 60%-80% . •Viridans streptococco: 30%-40% . •Otros streptococcos: 15%-25%. •Enterococcos: 5%-18% . •Coagulasa-positivos: 10%-27%•Coagulasa-negative: 1 %-3%•Bacilos Gram-negativos: 1% -13% •Hongos: 2%-4% •Staphylococco: 20%-35%
![Page 18: Guias endocarditis 2015](https://reader038.vdocuments.mx/reader038/viewer/2022110108/587303511a28ab99088b4c1b/html5/thumbnails/18.jpg)
Támbien comunment implicadol: Pseudomonas aeruginosa
Candida es común en adictos a heroina
El agente etiológico más común: S. aureus
Usuarios de drogas EV
![Page 19: Guias endocarditis 2015](https://reader038.vdocuments.mx/reader038/viewer/2022110108/587303511a28ab99088b4c1b/html5/thumbnails/19.jpg)
En pacientes con valvulas protesicas, los agentes etiologicos dependen del tiempo del reemplazo Temprana (menos de 12 meses) Tardía ( más de 12 meses)
Staphylococco 40% to 60% de los casos en E.I. temprana staphylococco Coagulasa-negativo - 30% a 35% • S. Aureus - 20% a 25%.
En la tardía los agentes etiologicos son los mismo que la E.I. de valvula native.
![Page 20: Guias endocarditis 2015](https://reader038.vdocuments.mx/reader038/viewer/2022110108/587303511a28ab99088b4c1b/html5/thumbnails/20.jpg)
![Page 21: Guias endocarditis 2015](https://reader038.vdocuments.mx/reader038/viewer/2022110108/587303511a28ab99088b4c1b/html5/thumbnails/21.jpg)
• Endocarditis fungica• Usuarios de drogas EV• POP cirugía cardiovascular reciente.• Exposición prolongada a AB de amplio
espectro.
![Page 22: Guias endocarditis 2015](https://reader038.vdocuments.mx/reader038/viewer/2022110108/587303511a28ab99088b4c1b/html5/thumbnails/22.jpg)
HACEK organismos
Account for approximately 5% to 10% of cases of community-acquired endocarditis.
•H: Haemophilus parainfluenzae, Haemophilus aphrophilus, Haemophilus paraphrophilus, .Haemophilus influenzae .•A : Actinobacillus actinomycetemcomitans .•C : Cardiobacterium hominis .•E : Eikenella corrodens •K: Kingella kingae, Kingella denitrificans
![Page 23: Guias endocarditis 2015](https://reader038.vdocuments.mx/reader038/viewer/2022110108/587303511a28ab99088b4c1b/html5/thumbnails/23.jpg)
Microorganismos menos frecuentes
![Page 24: Guias endocarditis 2015](https://reader038.vdocuments.mx/reader038/viewer/2022110108/587303511a28ab99088b4c1b/html5/thumbnails/24.jpg)
![Page 25: Guias endocarditis 2015](https://reader038.vdocuments.mx/reader038/viewer/2022110108/587303511a28ab99088b4c1b/html5/thumbnails/25.jpg)
CRÍTERIOSDIAGNOSTICOS
![Page 26: Guias endocarditis 2015](https://reader038.vdocuments.mx/reader038/viewer/2022110108/587303511a28ab99088b4c1b/html5/thumbnails/26.jpg)
Críterios modificados de Duke
![Page 27: Guias endocarditis 2015](https://reader038.vdocuments.mx/reader038/viewer/2022110108/587303511a28ab99088b4c1b/html5/thumbnails/27.jpg)
Críterios mayores y menores
![Page 28: Guias endocarditis 2015](https://reader038.vdocuments.mx/reader038/viewer/2022110108/587303511a28ab99088b4c1b/html5/thumbnails/28.jpg)
![Page 29: Guias endocarditis 2015](https://reader038.vdocuments.mx/reader038/viewer/2022110108/587303511a28ab99088b4c1b/html5/thumbnails/29.jpg)
FACTORES PRONOSTICOS
![Page 30: Guias endocarditis 2015](https://reader038.vdocuments.mx/reader038/viewer/2022110108/587303511a28ab99088b4c1b/html5/thumbnails/30.jpg)
Predictores de peor desenlace
![Page 31: Guias endocarditis 2015](https://reader038.vdocuments.mx/reader038/viewer/2022110108/587303511a28ab99088b4c1b/html5/thumbnails/31.jpg)
![Page 32: Guias endocarditis 2015](https://reader038.vdocuments.mx/reader038/viewer/2022110108/587303511a28ab99088b4c1b/html5/thumbnails/32.jpg)
![Page 33: Guias endocarditis 2015](https://reader038.vdocuments.mx/reader038/viewer/2022110108/587303511a28ab99088b4c1b/html5/thumbnails/33.jpg)
TRATAMIENTOANTIBIOTICO
![Page 34: Guias endocarditis 2015](https://reader038.vdocuments.mx/reader038/viewer/2022110108/587303511a28ab99088b4c1b/html5/thumbnails/34.jpg)
Streptococco bovis y otros streptococco orales
![Page 35: Guias endocarditis 2015](https://reader038.vdocuments.mx/reader038/viewer/2022110108/587303511a28ab99088b4c1b/html5/thumbnails/35.jpg)
Resistencia a penicilina:
![Page 36: Guias endocarditis 2015](https://reader038.vdocuments.mx/reader038/viewer/2022110108/587303511a28ab99088b4c1b/html5/thumbnails/36.jpg)
Antibiotic treatment - staphylo-cocci
![Page 37: Guias endocarditis 2015](https://reader038.vdocuments.mx/reader038/viewer/2022110108/587303511a28ab99088b4c1b/html5/thumbnails/37.jpg)
![Page 38: Guias endocarditis 2015](https://reader038.vdocuments.mx/reader038/viewer/2022110108/587303511a28ab99088b4c1b/html5/thumbnails/38.jpg)
enterococci –Valvula protesica
![Page 39: Guias endocarditis 2015](https://reader038.vdocuments.mx/reader038/viewer/2022110108/587303511a28ab99088b4c1b/html5/thumbnails/39.jpg)
Antibiotico en E.I. con hemocultivos negativos
![Page 40: Guias endocarditis 2015](https://reader038.vdocuments.mx/reader038/viewer/2022110108/587303511a28ab99088b4c1b/html5/thumbnails/40.jpg)
Tratamiento empirico en pacientes críticos
![Page 41: Guias endocarditis 2015](https://reader038.vdocuments.mx/reader038/viewer/2022110108/587303511a28ab99088b4c1b/html5/thumbnails/41.jpg)
Antibiotico parenteral ambulatorio
![Page 42: Guias endocarditis 2015](https://reader038.vdocuments.mx/reader038/viewer/2022110108/587303511a28ab99088b4c1b/html5/thumbnails/42.jpg)
MANEJO QUIRURGICO
![Page 43: Guias endocarditis 2015](https://reader038.vdocuments.mx/reader038/viewer/2022110108/587303511a28ab99088b4c1b/html5/thumbnails/43.jpg)
Indicaciones y tiempo de cirugía en E.I: de valvula izquierda
![Page 44: Guias endocarditis 2015](https://reader038.vdocuments.mx/reader038/viewer/2022110108/587303511a28ab99088b4c1b/html5/thumbnails/44.jpg)
Indicaciones quirurgicas en EI de valvulas derechas
![Page 45: Guias endocarditis 2015](https://reader038.vdocuments.mx/reader038/viewer/2022110108/587303511a28ab99088b4c1b/html5/thumbnails/45.jpg)
Factores asociados con recurrencia
![Page 46: Guias endocarditis 2015](https://reader038.vdocuments.mx/reader038/viewer/2022110108/587303511a28ab99088b4c1b/html5/thumbnails/46.jpg)
Endocarditis infeciosa relacionada con dispositivos cardiacos (CDRIE)
![Page 47: Guias endocarditis 2015](https://reader038.vdocuments.mx/reader038/viewer/2022110108/587303511a28ab99088b4c1b/html5/thumbnails/47.jpg)
Diagnostico
![Page 48: Guias endocarditis 2015](https://reader038.vdocuments.mx/reader038/viewer/2022110108/587303511a28ab99088b4c1b/html5/thumbnails/48.jpg)
Manejo
![Page 49: Guias endocarditis 2015](https://reader038.vdocuments.mx/reader038/viewer/2022110108/587303511a28ab99088b4c1b/html5/thumbnails/49.jpg)
Remoción del dispositivo
![Page 50: Guias endocarditis 2015](https://reader038.vdocuments.mx/reader038/viewer/2022110108/587303511a28ab99088b4c1b/html5/thumbnails/50.jpg)
Re-implantación
![Page 51: Guias endocarditis 2015](https://reader038.vdocuments.mx/reader038/viewer/2022110108/587303511a28ab99088b4c1b/html5/thumbnails/51.jpg)
Profilaxis
![Page 52: Guias endocarditis 2015](https://reader038.vdocuments.mx/reader038/viewer/2022110108/587303511a28ab99088b4c1b/html5/thumbnails/52.jpg)
![Page 53: Guias endocarditis 2015](https://reader038.vdocuments.mx/reader038/viewer/2022110108/587303511a28ab99088b4c1b/html5/thumbnails/53.jpg)
TERAPIA ANTITROMBOTICA