QbaerMed: Infectious endocarditis

有關牙科處置前的抗生素預防

有產生感染性心內膜炎高危險性的病人，可受益於牙科處置前的抗生素預防。美國心臟醫學會 (AHA guidline 2007) 的建議具體列出下列病人。

http://my.americanheart.org/professional/StatementsGuidelines/ByTopic/TopicsD-H/Endocarditis_UCM_321487_Article.jsp

Amoxicillin為預防的首選藥物，除非病人對penicillin過敏或無法口服藥物，則有以下其他選擇。

典型的周邊病變表現

A: Splinter hemorrhage: 指甲下的線狀出血

B: Conjunctiva petechia: 結膜紫斑

C: Osler nodes: 位於手指腹與腳趾腹的腫痛結節

D: Janeway lesion: 分布於手掌與腳掌的無痛出血性斑點

http://www.nejm.org/doi/pdf/10.1056/NEJMra010082

E: Roth's spots: 視網膜出現白色中心的出血點

D/D: Roth's spots, or white-centered retinal hemorrhages, may be seen in a variety of conditions, including leukemia, subacute bacterial endocarditis, ischemic events associated with elevated venous pressure, and systemic vascular conditions with capillary fragility.

http://www.nejm.org/doi/full/10.1056/NEJMicm040783