[Masks of subacute infectious endocarditis].
OBJECTIVE
Formulation of approaches to differential diagnosis and treatment policy for subacute infectious endocarditis (SIE) when it is masked by another monoorganic or systemic disease.


METHODS
The course of SIE was analysed in 132 patients of whom 74(56%) had erroneous admittance diagnoses. Rheumocarditis was not confirmed in 34 patients, 24 patients had nonspecific reactions masking SLE (4 cases), glomerulonephritis (7 cases), myocarditis (4 cases), hemorrhagic vasculitis, nodular periarteritis, polymyositis (9 cases).


RESULTS
The "masks" made the SIE diagnosis more difficult, resulted in late or invalid treatment--monotherapy with steroid hormones, in particular. This complicated the diagnostic process and aggravated the disease course.


CONCLUSIONS
To detect SIE it is necessary besides analysis of case record and symptoms to performe echocardiography in dynamics, because of possible late development of valvular defect. High-dose antibiotic therapy is justified for diagnosis of ex juvantibus when the diagnosis remains controversial.
Taranova
M V
MV
Belokrinitskaia
O A
OA
Kozlovskaia
L V
LV
Mukhin
N A
NA
D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D004452:Echocardiography; D004698:Endocarditis, Subacute Bacterial / Q000175:diagnosis* / Q000188:drug therapy; D005260:Female; D006351:Heart Valves / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male
D000900:Anti-Bacterial Agents