Endokarditis

Zusammenfassung

Die infektiöse Endokarditis stellt eine schwerwiegende und komplikationsträchtige Infektion mit erheblichen Sterblichkeitsraten dar. Es hat sich ein epidemiologischer Wandel hin zu Gesundheitssystem-assoziierter Endokarditis vollzogen, Haupterreger sind heute Staphylokokken. Bei hochgradigem Verdacht auf Vorliegen einer Endokarditis bleibt die transösophageale Echokardiografie der Standard in der bildgebenden Diagnostik. Neuere bildgebende Methoden wie 3D-TEE, Kardio-CT, FDG-PET/CT bleiben spezifischen Fragestellungen vorbehalten. Die 2015 veröffentlichten Leitlinien der European Society of Cardiology (ESC) beinhalten im Vergleich zur zeitgleich veröffentlichten Leitlinie der Amercian Heart Association (AHA) einige umstrittene Empfehlungen, insbesondere im Hinblick auf die Antibiotika-Therapie der Staphylokokken-Endokarditis. Propionibacterium acnes und Coxiella burnetii stellen Endokarditis-Erreger dar, für die diagnostische und therapeutische Besonderheiten gelten.

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