JCSGL IE Digest0701 update - 一般社団法人 日本 ...

1 2020 8 20 . 2018 4 12 . 2016 2017 .. 2017 . Guidelines for Prevention and Treatment of Infective Endocarditis (JCS 2017).. / .. 2017 12 . 1.. I 6 2 16. 1 6 a 16. 2 6 b 16. c / 16. II 8 d 16. 1 IE 8 3 17. 2 8 17. 3 8 17. 18. III 9 HACEK 22. 1 IE 9 23. 2 9 4 23. / 9. 9 V 24. 3 11 1 24. 11 a 24. 12 b 24. 4 12 c 25. a 12 2 25. b 12 a 25. c 12 b 25. d TTE TEE 12 3 26. e 13 26. f 13 26. 5 13 CQ 1 IE . a CT 13 IE MRI 27. b MRI 13 28. c /CT 13 4 30. d F-FDG PET/CT 14. 18. a IE 30. e 14 b IE 30. 6 14 5 30. IV 15 VI 30. 1 15 1 30. a PK/PD 15 a 30. b 15 b . c 30. 15 2 30.

2 D a 30. 15 b 31. e 15 c 32. d 32. 2.. CQ 2 42. 32 42. CQ 3 42. IE 33 . e 33 42. 3 34 42. a IE 34 IE . b IE 34 43. c 34. IX 43. VII 35 1 IE 43. a 35 IE 43. b 44. 35 44. c 35 46. d 35 48. CQ 5 / . VIII 36 . 1 IE 36 IE 49. 2 IE 37 2 49. a IE 37 a 49. b 37 b 49. c 37 c 49. d / 37 d 50. e 37 e 50. f 37 3 IE 51. g 37 4 IE 51. h 37 5 NBTE 51. 3 IE 37 6 IE 52. 37. 38 53. CQ 4 . 54. 41. 41 . 42. 3.. ACC American College of Cardiology IE infective endocarditis . AHA American Heart Association matrix-assisted laser desorption . MALDI- ionization-time of flight mass.

3 TOF MS. BNP brain natriuretic peptide spectrometry .. CA-MRSA community-associated MRSA MRSA MDCT multidetector-row CT CT. cardiac device related infective MIC minimum inhibitory concentration . CDRIE IE. endocarditis CK creatine kinase MRA magnetic resonance angiography . Clinical and Laboratory MRI magnetic resonance imaging . CLSI. Standards Institute . methicillin-resistant . CNS coaglase negative staphylococci MRSA. Staphylococcus aureus . methicillin-sensitive . CQ clinical question MSSA. Staphylococcus aureus . nonbacterial thrombotic . CRP C-reactive protein NBTE.

4 Endocarditis . National Institute for Health and . CT computed tomography NICE. Care Excellence . computed tomography NVS nutritionally variant streptococci . CTA. angiography . disseminated intravascular NYHA New York Heart Association . DIC. coagulation syndrome . DWI diffusion weighted image PCR polymerase chain reaction . ESC European Society of Cardiology PD pharmacodynamics . European Committee on PET positoron emission tomography .. EUCAST Antimicrobial Susceptibility . Testing PK pharmacokinetics . 18 18. 18. F- . F-FDG F-fluorodeoxyglucose . SLE systemic lupus erythematosus fluid attenuated inversion.

5 FLAIR . recovery SWI susceptibility-weighted imaging . Ga gallium . TDM therapeutic drug monitoring . Haemophilus aphrophilus, Haemophilus paraphrophilus, transesophageal TEE . Aggregatibacter echocardiography HACEK actinomycetemcomitans, Cardiobacterium hominis, TTE transthoracic echocardiography . Eikenella corrodens, Kingella kingae VGS viridans group streptococci . 99m 99m 99m Tc- . Tc- Tc-hexamethylpropylene . VRE vancomycin resistant enterococci HMPAO amine oxime .. IDU intravenous drug user . 4.. / . AZM Azithromycin . AMK Amikacin . AMPH L-AMB Amphotericin-B.

6 AMPC Amoxicillin . ABK Arbekacin . ABPC Ampicillin . IPM/CS Imipenem/cilastatin . CPFG Caspofungin . CAM Clarithromycin . CLDM Clindamycin . GM Gentamicin . CPFX Ciprofloxacin . SM Streptomycin . SBT/ABPC Sulbactam/ampicillin . ST Sulfamethoxazole/trimethoprim . CCL Cefaclor . CEZ Cefazolin . CDX Cefadroxil . CEX Cefalexin . CTX Cefotaxime . CDTR Cefditoren . CTRX Ceftriaxone . DAP Daptomycin . TEIC Teicoplanin . PAPM/BP Panipenem/betamipron . VCM Vancomycin . G PCG Penicillin G Benzylpenicillin G. FOM Fosfomycin . VRCZ Voriconazole . MCFG Micafungin.

7 MEPM Meropenem . LZD Linezolid . RFP Rifampicin . LVFX Levofloxacin . 5.. I . CQ . 1.. Minds 2014 . A D 1 . I III . A C . EBM Minds . 5 CQ . CQ 1 .. 1 .. 1 IE 2 .. 2 IE . A .. B .. C . 3 IE . D .. 4 IE IE . nonbacterial thrombotic endocarditis NBTE . 1 2 . IE .. IE 1 . I.. 1 .. 2. a . b .. 5 CQ .. 3 . CQ . 6. II . 2 .. A.. B.. / . C.. 3 .. IE IE MRI . V 3.. V b. 18 . CQ1. IE IE . 2 C . MRI DWI FLAIR T2 MRA .. VI 2.. VI 2. a. 20 . CQ2. 10 mm IE . 1 B .. IE . VI 2.. VI 2. a.. 20 . IE . 1 B . CQ3 .. 4 . 2 C .. IE . VIII 3. IE .. VIII 1. IE . 22 . CQ4 . 1 B.

8 2 C .. / IE . IX 1. IE .. IX .. 28 . CQ5 / . 1 C .. / . 2 C .. IE MRI DWI FLAIR MRA . 7.. II . 1 2 . IE . IE IE. vegetation IE. 2 4 .. NBTE . NBTE . NBTE . 3 . IE .. IE IE IE .. IE .. Duke .. 1 . computed . tomography CT vegetation . positoron emission tomography 2 . PET . Streptococcus viridans . 8. III . III . 20% .. 1 Staphylococcus IE aureus .. IE Duke IE . 4 5, 6 Duke 80% . IE . IX 2. p. 49 .. 7, 8 . IE . CT 18. F- IE 19%. F-fluorodeoxyglucose F-FDG PET/CT . 18 18. 16% . F-FDG PET/CT 18.. IE 11 . ESC . 5 1 .. 2 . 20% . Janeway . 5 10% . Osler 3 10%.

9 30% . splinter hemorrhage 10% .. Roth 2 10% 10 12 . 80% 10 . / . 13 Duke IE IE 4 5, 6, 14, 15 .. 50% .. 9 . 30% . 45% Duke 30% 16 . 4 1 IE 50% 17 .. 25% 10 18 .. 2 . 30% . 19 30 . 9.. 4 IE Duke .. 1 .. 2 . a . 1 2 . 2 1 3 . 3 5 .. 1 1 1 . 2 3 .. 1 IE . 2 IE 4 . 3 4 IE . 4 .. a .. IE . 2 IE . Streptococcus viridans Streptococcus bovis Streptococcus gallolyticus HACEK . Staphylococcus aureus Enterococcus IE . 12 2 . 3 4 . 1 . 1 Coxiella burnetii I IgG 800 .. IE IE TEE . TTE .. C . Janeway . Osler Roth . IE . b .. IE 1 . b . IE TEE TTE . Li JS, et al. 2000 6.

10 1 30 40% 20 Staphylococcus aureus . mycotic aneurysm IE . 1 5% . 10 30% . 30 55% 21, 22 .. 10. III .. 30 1 6 27 . 3 .. 5 ESC IE . IE . a IE .. IE .. IE . Staphylococcus aureus . b 18F-FDG PET/CT 3 . 5 30% IE 23, 24 SPECT/CT .. c CT . 90% ESC Duke 4 . IE 1 .. ESC IE F-FDG 18F- . 18. 25, 26 3 .. Habib G, et al. 2015 2 . IE . Duke .. 1 TTE TEE / 1 TTE TEE / . 2 2 18F-FDG PET/CT. 3 CT 3 CT. 4 . ESC .. IE TTE TEE ESC . 1 IE . 11.. 2 . 1 4 . 2 3 .. IE . IE . IE . 33, 34 . 3 48 72 a . 28 Duke 4 .. b .. a . IE Bartonella Coxiella burnetii .. Bartonella Bartonella quintana.