title: [Contribution of the Duke's classification in the emergency department in the early management of infective endocarditis].
abstract: The diagnosis of infective endocarditis is based on multiple clinical signs than on a single positive test result. The contribution of echocardiography is an indispensable asset to avoid misdiagnosis or delayed correct diagnosis. A 24-year old woman is admitted to the emergency room. She has a poor general condition, pyrexia and necrotic lesions on the body. After examination, the diagnosis of multiple organ failure and severe sepsis from infective endocarditis from intravenous injections of cocaine is made and the patient is transferred to ICU. She is treated with vancomycin for 4 weeks and gentamicin for 8 days. Her clinical improvement allows her to be transferred to a hospital unit at day 6. She goes home after 28 days of hospitalization. Several sets of criteria for the diagnosis of infective endocarditis are described. The most commonly accepted are revised Duke's criteria that take into account echocardiography. This article aims, through a clinical case, to describe this classification too little used in the emergency room.
authors.forename: C
authors.initials: C
authors.lastname: Hautain
authors.forename: P
authors.initials: P
authors.lastname: Delleuze
authors.forename: C
authors.initials: C
authors.lastname: Godefroid
authors.forename: M
authors.initials: M
authors.lastname: Vranckx
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D016470:Bacteremia / Q000150:complications*; D004359:Drug Therapy, Combination; D042241:Early Diagnosis; D004452:Echocardiography; D004636:Emergency Service, Hospital; D004696:Endocarditis / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D005260:Female; D005334:Fever / Q000382:microbiology; D005839:Gentamicins / Q000627:therapeutic use; D006801:Humans; D007362:Intensive Care Units; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D015819:Substance Abuse, Intravenous / Q000150:complications*; D016896:Treatment Outcome; D014640:Vancomycin / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D005839:Gentamicins; D014640:Vancomycin