Avtor/Urednik		Lejko-Zupanc, Tatjana; Brecelj, Aleš
Naslov		Endokarditis ob elektrodi srčnega spodbujevalnika
Prevedeni naslov		Pace-maker related infective endocarditis
Tip		članek
Vir		Zdrav Vestn
Vol. in št.		Letnik 74, št. Suppl 1
Leto izdaje		2005
Obseg		str. I-67-70
Jezik		slo
Abstrakt		Background. To describe clinical picture, treatment and outcome of the disease in patients with pace-maker related endocarditis. Methods. All the patients fulfilling the Duke patomorphological and clinical criteria for infective endocarditis on pace-maker wire or near it are included. Clinical and demographic data are recorded as well as the time since the implantation of pacemaker, site of infection, portal of entry, causative agent, size and localization of vegetation, mode of operation and outcome of the disease. Results. Since the year 1984 10 episodes of paced-maker-related endocarditis in 9 patients (8 males, 1 female) were treated at the Department of Infectious Diseases and that represents 2,5% of all episodes of infective endocarditis treated at the department. The causative micro-organisms were isolated in 9 out of 10 episodes, mostly there were coagulase negative staphylococci. One patient died before the operation and another patient after the operation. Overall moratlity was 20%. Eight out of 9 patients were operated. Complete paced-maker system or only retained leads were extracted. None of the patients who survived the operation had a relapse of the disease. Conclusions. Pace-maker related endocarditis is rare. Complete cure is usually impossible without combined surgical therapy and long-term antibiotic treatment.
Izvleček		Izhodišča. Opisati klinično sliko, potek zdravljenja in izhod bolezni pri bolnikih z endokarditisom ob srčnem spodbujevalniku. Metode. Vključeni so vsi bolniki, ki po kliničnih in patomorfoloških Dukovih merilih izpolnjujejo pogoje za diagnozo infekcijskega endokarditisa in imajo okužbe bodisi na elektrodi spodbujevalnika ali ob njej. Opisane klinične in demografske spremenljivke, kakor tudi čas od vstavitve spodbujevalnika, kraj okužbe, vstopno mesto okužbe, osamljeni povzročitelj, velikost in lokalizacija vegetacije, vrsta operacije in izhod bolezni. Rezultati. Od leta 1984 smo na Kliniki za infekcijske bolezni in vročinska stanja zdravili 10 epizod infekcijskega endokarditisa ob srčnem spodbujevalniku pri 9 bolnikih (8 moških, 1 ženska), kar predstavlja 25% vseh epizod infekcijskega endokarditisa, zdravljenih na kliniki. Povzročitelja smo dokazali pri 9 od 10 epizod, večinoma so bili to koagulaza negativni stafilokoki. Pred operacijo je umrl en bolnik, po operaciji pa še ena bolnica. Celotna smrtnost je bila 20%. Osem od 9 bolnikov je bilo operiranih. Odstranjen je bil srčni spodbujevalnik bodisi v celoti bodisi le retinirane elektrode. Pri nobenem od bolnikov, ki so operacijski poseg uspešno prestali, ni prišlo do recidiva bolezni. Zaključki. Endokarditis ob elektrodi spodbujevalnika je redek. Ozdravitev praviloma ni možna brez operacijskega posega v kombinaciji z dolgotrajnim antibiotičnim zdravljenjem.
Deskriptorji		CARDIAC PACING, ARTIFICIAL ENDOCARDITIS, BACTERIAL ECHOCARDIOGRAPHY ELECTRODES, IMPLANTED TREATMENT OUTCOME