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Clinical Characteristics and Outcome of Patients with Infective Endocarditis Diagnosed in a Department of Internal Medicine

CHU Lille, Département de médecine interne et immunologie clinique, F-59000 Lille, France
Centre de Référence des Maladies Autoimmunes et Systémiques Rares du Nord et Nord-Ouest de France (CeRAINO), Hôpital Claude Huriez, F-59000 Lille, France
CHU Lille, Department of Clinical Physiology & Echocardiography, Heart Valve Clinic, F-59000 Lille, France
Univ. Lille, Inserm U1011, Institut Pasteur de Lille, EGID, F-59000 Lille, France
Univ. Lille, U1286, INFINITE, Institute for Translational Research in Inflammation, F-59000 Lille, France
Inserm, U1286, F-59000 Lille, France
Author to whom correspondence should be addressed.
J. Clin. Med. 2020, 9(3), 864;
Received: 14 February 2020 / Revised: 16 March 2020 / Accepted: 19 March 2020 / Published: 21 March 2020
(This article belongs to the Special Issue Infective Endocarditis)
Clinical manifestations of infective endocarditis (IE) can be highly non-specific. Our objective was to describe the clinical characteristics of patients initially referred to a department of internal medicine for a diagnostic work-up, and eventually diagnosed with IE. We retrospectively retrieved adult patients admitted to the department of internal medicine at Lille University Hospital between 2004 and 2015 who fulfilled Duke Classification criteria for definite IE. Thirty-five patients were included. The most frequently involved bacteria were non-hemolytic streptococci. Most patients presented with various systemic, cardiac, embolic, rheumatic, and immunological findings, with no sign or symptom displaying high sensitivity. The first transthoracic echocardiogram was negative in 42% of patients. Furthermore, definite diagnosis required performing at least 2 transesophageal examinations in 24% of patients. We observed a trend towards decreased survival in the subgroup of patients in whom the delay between onset of symptoms and diagnosis was >30 days. In conclusion, patients who are initially referred to internal medicine for a diagnosis work-up and who are ultimately diagnosed with IE have non-specific symptoms and a high percentage of initial normal echocardiography. Those patients require prolonged echocardiographic monitoring as a prolonged delay in diagnosis is associated with poorer outcomes such as death. View Full-Text
Keywords: infective endocarditis; internal medicine; echocardiography; diagnosis infective endocarditis; internal medicine; echocardiography; diagnosis
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Kreitmann, L.; Montaigne, D.; Launay, D.; Morell-Dubois, S.; Maillard, H.; Lambert, M.; Hachulla, E.; Sobanski, V. Clinical Characteristics and Outcome of Patients with Infective Endocarditis Diagnosed in a Department of Internal Medicine. J. Clin. Med. 2020, 9, 864.

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