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Management of Gram-negative and fungal endocarditis.

Durante-Mangoni, Emanuele; Tripodi, Marie-Françoise; Albisinni, Rosina; Utili, Riccardo.
Int J Antimicrob Agents; 36 Suppl 2: S40-5, 2010 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-21129927
Infective endocarditis is infrequently caused by Gram-negative bacteria or fungi. Gram-negative organisms are responsible for <4% of cases, whilst fungal endocarditis accounts for <1.5% of culture-positive cases worldwide. Endocarditis due to Gram-negative organisms or fungi is a rare but severe disease. It often has a nosocomial origin, is caused by virulent and often resistant organisms and presents a high rate of complications and high mortality. In this article we present the most recent literature data and address the current management of Gram-negative and fungal infective endocarditis. We also discuss the major challenges of antimicrobial treatment and discuss some issues related to surgical decision-making in difficult-to-manage cases. We finally present our centre's experience with Gram-negative infective endocarditis, with a special focus on the demanding issues that the management of these complex and severely ill patients raise.
Selo DaSilva