Analysis of clinical background in patients with vegetation-like echoes: importance of clinical information.
OBJECTIVE
Detection of vegetation is important for diagnosing infective endocarditis.


METHODS
We analyzed clinical information from 58 patients with vegetation-like echoes on transthoracic echocardiography who had been referred to this institution for an echocardiographic examination during the past 5 years. Patients with healed vegetations were excluded. A vegetation-like echo was defined as a mass, a thread-like echo attached to the valve or endocardium, or both. Diagnosis of a vegetation-like echo required the concurrence of two cardiologists and one sonographer. Altogether, 44 patients were treated with antibiotics because their clinical courses were consistent with active infective endocarditis.


RESULTS
Blood cultures were positive in 27 patients and negative in 17 patients. Follow-up data were available for 10 of the 14 patients who had no findings suggestive of active infective endocarditis. The size of the vegetation-like echo remained unchanged over a mean interval of 12.1 months, and no clinical signs or symptoms of active infective endocarditis appeared. In about one-fourth of the patients with a vegetation-like echo, it was not associated with infective endocarditis.


CONCLUSIONS
Clinical information, in addition to detection of a vegetation-like echo, appears to be indispensable for diagnosing infective endocarditis.
Department of Clinical Pathology, Tenri Hospital, 200 Mishima-cho, Tenri, 632-8552, Japan. takahashism@muf.biglobe.ne.jp.
Shuichi
S
Takahashi
Department of Cardiology, Tenri Hospital, 200 Mishima-cho, Tenri, 632-8552, Japan.
Kanji
K
Iga
Department of Cardiology, Tenri Hospital, 200 Mishima-cho, Tenri, 632-8552, Japan.
Chisato
C
Izumi
Department of Cardiology, Tenri Hospital, 200 Mishima-cho, Tenri, 632-8552, Japan.
Takashi
T
Konishi
Clinical information; Echocardiography; Infective endocarditis; Vegetation