Sandbox ID Cardiovascular: Difference between revisions

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===Aortitis, infectious===
===Aortitis, infectious===


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===Myocarditis, viral===
===Myocarditis, viral===
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===Pericarditis, bacterial===
*Bacterial pericarditis
:* '''Empiric antimicrobial therapy'''<ref>{{cite book | last = Gilbert | first = David | title = The Sanford guide to antimicrobial therapy | publisher = Antimicrobial Therapy | location = Sperryville, Va | year = 2015 | isbn = 978-1930808843 }}</ref><ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
:::* Preferred regimen: [[Vancomycin]] 1 g IV q12h targeting trough levels of 15–20 μg/mL for 28 days {{and}} [[Ciprofloxacin]] 400 mg IV q12h for 28 days
:::* Alternative regimen (1): [[Vancomycin]] 1 g IV q12h targeting trough levels of 15–20 μg/mL for 28 days {{and}} [[Cefepime]] 2 g IV q12h for 28 days
:::* Alternative regimen (2): [[Vancomycin]] 1 g IV q12h targeting trough levels of 15–20 μg/mL for 14–42 days {{and}} [[Ceftriaxone]] 2 g IV q24h for 14–42 days
:::: Note: [[Pericardiocentesis]] must be promptly performed.  Pericardial drainage combined with effective systemic antibiotic therapy is mandatory (antistaphylococcal agent plus aminoglycoside, followed by tailored antibiotic therapy according to cultures).  Frequent irrigation of the pericardial cavity with [[urokinase]] or [[streptokinase]] may be considered.  Open surgical drainage through subxiphoid pericardiotomy is preferable.  [[Pericardiectomy]] may be required in patients with dense adhesions, loculated and thick purulent effusion, recurrence of tamponade, persistent infection, and progression to constriction.
:* Specific considerations<ref>{{Cite journal| doi = 10.1016/j.ehj.2004.02.002| issn = 0195-668X| volume = 25| issue = 7| pages = 587–610| last1 = Maisch| first1 = Bernhard| last2 = Seferović| first2 = Petar M.| last3 = Ristić| first3 = Arsen D.| last4 = Erbel| first4 = Raimund| last5 = Rienmüller| first5 = Reiner| last6 = Adler| first6 = Yehuda| last7 = Tomkowski| first7 = Witold Z.| last8 = Thiene| first8 = Gaetano| last9 = Yacoub| first9 = Magdi H.| last10 = Task Force on the Diagnosis and Management of Pricardial Diseases of the European Society of Cardiology| title = Guidelines on the diagnosis and management of pericardial diseases executive summary; The Task force on the diagnosis and management of pericardial diseases of the European society of cardiology| journal = European Heart Journal| date = 2004-04| pmid = 15120056}}</ref><ref>{{Cite journal| issn = 1175-3277| volume = 5| issue = 2| pages = 103–112| last1 = Pankuweit| first1 = Sabine| last2 = Ristić| first2 = Arsen D.| last3 = Seferović| first3 = Petar M.| last4 = Maisch| first4 = Bernhard| title = Bacterial pericarditis: diagnosis and management| journal = American Journal of Cardiovascular Drugs: Drugs, Devices, and Other Interventions| date = 2005| pmid = 15725041}}</ref><ref>{{Cite journal| issn = 1092-8464| volume = 2| issue = 4| pages = 343–350| last = Goodman| first = null| title = Purulent Pericarditis| journal = Current Treatment Options in Cardiovascular Medicine| date = 2000-08| pmid = 11096539}}</ref><ref>{{cite book | last = Cherry | first = James | title = Feigin and Cherry's textbook of pediatric infectious diseases | publisher = Elsevier/Saunders | location = Philadelphia, PA | year = 2014 | isbn = 978-1455711772 }}</ref>
::* '''Purulent pericarditis with contiguous pneumonia'''
:::* Preferred regimen: [[Vancomycin]] 1 g IV q12h targeting trough levels of 15–20 μg/mL {{and}} ([[Ceftriaxone]] 1–2 g IV q12h {{or}} [[Cefotaxime]] 2 g IV q6–8h) {{and}} ([[Ciprofloxacin]] 400 mg IV q12h {{or}} [[Levofloxacin]] 500–750 mg IV q24h)
::* '''Purulent pericarditis with contiguous head and neck infection'''
:::* Preferred regimen: [[Imipenem]] 500 mg IV q6–8h {{or}} [[Ampicillin-Sulbactam]] 3 g IV q6h
::* '''Purulent pericarditis secondary to infective endocarditis'''
:::* Preferred regimen: [[Vancomycin]] 15–20 mg/kg IV q8–12h targeting trough levels of 15–20 μg/mL {{and}} [[Gentamicin]] 3 mg/kg/day IV q8–12h
::* '''Purulent pericarditis after cardiac surgery, pediatric'''
:::* Preferred regimen: [[Vancomycin]] 15 mg/kg IV q6h targeting trough levels of 15–20 μg/mL {{and}} ([[Ceftriaxone]] 100 mg/kg/day IV q12–24h {{or}} [[Cefotaxime]] 200–300 mg/kg/day IV q6–8h) {{and}} [[Gentamicin]] 6–7.5 mg/kg/day IV q8h
::* '''Purulent pericarditis with genitourinary infection, pediatric'''
:::* Preferred regimen: [[Vancomycin]] 15 mg/kg IV q6h targeting trough levels of 15–20 μg/mL {{and}} ([[Ceftriaxone]] 100 mg/kg/day IV q12–24h {{or}} [[Cefotaxime]] 200–300 mg/kg/day IV q6–8h) {{and}} [[Gentamicin]] 6–7.5 mg/kg/day IV q8h
::* '''Purulent pericarditis in immunocompromised host, pediatric'''
:::* Preferred regimen: [[Vancomycin]] 15 mg/kg IV q6h targeting trough levels of 15–20 μg/mL {{and}} ([[Ceftriaxone]] 100 mg/kg/day IV q12–24h {{or}} [[Cefotaxime]] 200–300 mg/kg/day IV q6–8h) {{and}} [[Gentamicin]] 6–7.5 mg/kg/day IV q8h
:* Culture-directed antimicrobial therapy<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref>
::* '''Anaerobes'''
:::* Preferred regimen: [[Clindamycin]] 600–900 mg IV q8h for 14–42 days {{or}} [[Metronidazole]] 7.5 mg/kg IV q6h for 14–42 days {{or}} [[Ampicillin-Sulbactam]] 3 g IV q6h for 14–42 days
::* '''Gram-negative bacilli'''
:::* Preferred regimen: [[Ciprofloxacin]] 400 mg IV q12h for 14–42 days {{or}} [[Levofloxacin]] 500–750 mg IV q24h for 14–42 days {{or}} [[Cefepime]] 2 g IV q12h for 14–42 days
::* '''Legionella pneumophila'''
:::* Preferred regimen: [[Ciprofloxacin]] 400 mg IV q12h for 14–42 days {{or}} [[Levofloxacin]] 500–750 mg IV q24h for 14–42 days {{or}} [[Azithromycin]] 500 mg IV q24h for 14–42 days
::* '''Mycoplasma pneumoniae'''
:::* Preferred regimen: [[Doxycycline]] 100 mg IV q12h for 14–42 days {{or}} [[Azithromycin]] 500 mg IV q24h for 14–42 days
::* '''Neisseria meningitidis'''
:::* Preferred regimen: [[Penicillin G]] 5–24 MU/day IM/IV q4–6h for 14–42 days {{or}} [[Cefotaxime]] 2 g IV q6–8h for 14–42 days {{or}} [[Ceftriaxone]] 2 g IV q24h for 14–42 days
::* '''Staphylococcus aureus, methicillin-susceptible'''
:::* Preferred regimen: [[Nafcillin]] 1–2 g IV q4h for 14–42 days {{or}} [[Oxacillin]] 1–2 g IV q4h for 14–42 days {{or}} [[Cefazolin]] 1–2 g IV q48h for 14–42 days {{or}} [[Vancomycin]] 1 g IV q12h targeting trough levels of 15–20 μg/mL for 14–42 days {{or}} [[Clindamycin]] 600–900 mg IV q8h for 14–42 days
::* '''Staphylococcus aureus, methicillin-resistant'''
:::* Preferred regimen: [[Vancomycin]] 1 g IV q12h targeting trough levels of 15–20 μg/mL for 14–42 days {{or}} [[Linezolid]] 600 mg IV q12h for 14–42 days
::* '''Streptococcus pneumoniae, penicillin-susceptible'''
:::* Preferred regimen: [[Penicillin G]] 5–24 MU/day IM/IV q4–6h for 14–42 days {{or}} [[Cefotaxime]] 2 g IV q6–8h for 14–42 days {{or}} [[Ciprofloxacin]] 400 mg IV q12h for 14–42 days {{or}} [[Levofloxacin]] 500–750 mg IV q24h for 14–42 days
::* '''Streptococcus pneumoniae, penicillin-resistant'''
:::* Preferred regimen: [[Ciprofloxacin]] 400 mg IV q12h for 14–42 days {{or}} [[Levofloxacin]] 500–750 mg IV q24h for 14–42 days {{or}} [[Vancomycin]] 1 g IV q12h targeting trough levels of 15–20 μg/mL for 14–42 days


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===Pericarditis, tuberculous===
===Pericarditis, tuberculous===
<!-- ''''Condition_Or_Pathogen'''
:* Preferred regimen: [[DrugName]] Dosage_Duration
:* Alternative regimen: [[DrugName]] Dosage_Duration-->


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Revision as of 21:09, 2 June 2015

Aortitis, infectious

Cardiovascular implantable electronic device infections

Endocarditis, prophylaxis

Intravascular catheter-related infections

Mediastinitis, acute

Myocarditis, viral

Pericarditis, fungal

  • Fungal Pericarditis[1]
Note: Corticosteroids and NSAIDs can support the treatment with antifungal drugs. Pericardiocentesis or surgical treatment is indicated for haemodynamic impairment. Pericardiectomy is indicated in fungal constrictive pericarditis.
Note: Corticosteroids and NSAIDs can support the treatment with antifungal drugs. Pericardiocentesis or surgical treatment is indicated for haemodynamic impairment. Pericardiectomy is indicated in fungal constrictive pericarditis.
  • Preferred regimen: Combination of three antibiotics including Penicillin.
Note: Corticosteroids and NSAIDs can support the treatment with antifungal drugs. Pericardiocentesis or surgical treatment is indicated for haemodynamic impairment. Pericardiectomy is indicated in fungal constrictive pericarditis.

Pericarditis, tuberculous

Pericarditis, viral

  • Viral pericarditis[1]
  • CMV pericarditis
  • Preferred regimen: immunoglobulin 1 time per day 4 ml/kg on day 0, 4, and 8; 2 ml/kg on day 12 and 16.
Note: Symptomatic treatment is given to the patients with viral pericarditis while in large effusions and cardiac tamponade pericardiocentesis is necessary. The use of corticosteroid therapy is contraindicated except in patients with secondary tuberculous pericarditis, as an adjunct to tuberculosis treatment. Drainage, if needed is done.
  • Coxsackie B pericarditis
  • Preferred regimen: Interferon alpha or beta 2,5 Mio. IU/m2 surface area s.c. 3×per week.
Note: Symptomatic treatment is given to the patients with viral pericarditis while in large effusions and cardiac tamponade pericardiocentesis is necessary. The use of corticosteroid therapy is contraindicated except in patients with secondary tuberculous pericarditis, as an adjunct to tuberculosis treatment. Drainage, if needed is done.
  • Adenovirus and parvovirus B19 perimyocarditis
  • Preferred regimen: Immunoglobulin 10 g intravenously at day 1 and 3 for 6–8 hours
Note: Symptomatic treatment is given to the patients with viral pericarditis while in large effusions and cardiac tamponade pericardiocentesis is necessary. The use of corticosteroid therapy is contraindicated except in patients with secondary tuberculous pericarditis, as an adjunct to tuberculosis treatment. Drainage, if needed is done.

Rheumatic fever, primary prophylaxis

Rheumatic fever, secondary prophylaxis

Septic pelvic vein thrombophlebitis

  • Right ovarian vein thrombosis
Note: Repeat CT scan after 3 months. If negative, stop anticoagulation. If still positive for thrombi, anticoagulate for 3 additional months.
  • Pelvic branch vein thrombosis
  • Negative for pelvic thrombi

References

  1. ↑ 1.0 1.1 Maisch B, Seferović PM, Ristić AD, Erbel R, Rienmüller R, Adler Y; et al. (2004). "Guidelines on the diagnosis and management of pericardial diseases executive summary; The Task force on the diagnosis and management of pericardial diseases of the European society of cardiology". Eur Heart J. 25 (7): 587–610. doi:10.1016/j.ehj.2004.02.002. PMID 15120056.
  2. ↑ Javier Garcia, Ramzi Aboujaoude, Joseph Apuzzio & Jesus R. Alvarez (2006). "Septic pelvic thrombophlebitis: diagnosis and management". Infectious diseases in obstetrics and gynecology. 2006: 15614. doi:10.1155/IDOG/2006/15614. PMID 17485796.
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