endocardite infecciosa em câmaras direitas: discrepância entre evolução clínica e ecocardiogr��fica: relato de caso right-side infective endocarditis: discrepancy between clinical and echocardiographic evolution: case report

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ID: 255139
2009
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Abstract
A endocardite infecciosa é uma patologia relativamente rara na prática clínica, e, apesar dos avanços em seu diagnóstico e tratamento, sua morbi-mortalidade ainda é significativa. Muitas vezes é difícil a identificação de suas complicações e a conduta frente a elas, ocorrendo com freqüência a dissociação entre a evolução clínica e os achados de exames complementares - principalmente ecocardiográficos. A decisão clínica torna-se ainda mais difícil frente às manifestações atípicas da doença, como a endocardite de câmaras direitas. Este é o relato de um caso raro de endocardite de câmaras direitas em uma paciente renal crônica, cuja piora dos achados ecocardiográficos se opunha à evolução clínica favorável. Esta situação pode suscitar dificuldade quanto aos critérios para indicação cirúrgica e a segurança do tratamento conservador.
Infective endocarditis is a relatively rare disease in clinical practice, with significant morbidity and mortality despite the improvements on its diagnosis and treatment. It is often difficult to identify its complications and define strategies for them. Dissociation between the clinical evolution and the findings from complementary tests (especially echocardiographic tests) is common. Clinical decisions become even more difficult when there are atypical manifestations of the disease, such as right-side endocarditis. This report is about a rare case of right-side endocarditis in a patient with chronic renal disease, in which there was a contradiction between worsening of the echocardiographic findings and clinical improvement. This situation may lead to difficulties regarding the criteria for indicating surgery and the safety of conservative clinical treatment.
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nascimento2009revistaendocardite Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors ;Bruno Ramos Nascimento;Thaíssa Oliveira de Almeida A. Coelho;Lucas Rocha da Costa Filho;Marcelo Martins Pinto Filho;Vitor Emanuel Serafim Cota;Renata de Carvalho Bicalho;Antonio Luiz Pinho Ribeiro;Maria do Carmo Pereira Nunes
Journal mobile information systems
Year 2009
DOI
10.1590/S0037-86822009000500020
URL
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822009000500020
Keywords
clinical management endocarditis tratamento tropical medicine treatmentarctic medicine right-side chambers

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