Infectious endocarditis
Endocarditis infecciosa
Leído
16119
Vecesse ha leído el artículo
4640
Total PDF
11479
Total HTML
Compartir estadísticas
array:19 [ "pii" => "13080399" "issn" => "16954033" "estado" => "S300" "fechaPublicacion" => "2005-11-01" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "An Pediatr (Barc). 2005;63:383-8" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 4861 "formatos" => array:3 [ "EPUB" => 120 "HTML" => 4173 "PDF" => 568 ] ] "Traduccion" => array:1 [ "es" => array:17 [ "pii" => "13080400" "issn" => "16954033" "doi" => "10.1157/13080400" "estado" => "S300" "fechaPublicacion" => "2005-11-01" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "An Pediatr (Barc). 2005;63:383-9" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 26721 "formatos" => array:3 [ "EPUB" => 141 "HTML" => 24186 "PDF" => 2394 ] ] "es" => array:9 [ "idiomaDefecto" => true "titulo" => "Endocarditis infecciosa" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "383" "paginaFinal" => "389" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Infectious endocarditis" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "A Carceller" "autores" => array:1 [ 0 => array:2 [ "Iniciales" => "A" "apellidos" => "Carceller" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:8 [ "pii" => "13080399" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/13080399?idApp=UINPBA00005H" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/13080400?idApp=UINPBA00005H" "url" => "/16954033/0000006300000005/v0_201404151137/13080400/v0_201404151137/es/main.assets" ] ] "itemSiguiente" => array:17 [ "pii" => "13080400" "issn" => "16954033" "doi" => "10.1157/13080400" "estado" => "S300" "fechaPublicacion" => "2005-11-01" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "An Pediatr (Barc). 2005;63:383-9" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 26721 "formatos" => array:3 [ "EPUB" => 141 "HTML" => 24186 "PDF" => 2394 ] ] "es" => array:9 [ "idiomaDefecto" => true "titulo" => "Endocarditis infecciosa" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "383" "paginaFinal" => "389" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Infectious endocarditis" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "A Carceller" "autores" => array:1 [ 0 => array:2 [ "Iniciales" => "A" "apellidos" => "Carceller" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:8 [ "pii" => "13080399" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/13080399?idApp=UINPBA00005H" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/13080400?idApp=UINPBA00005H" "url" => "/16954033/0000006300000005/v0_201404151137/13080400/v0_201404151137/es/main.assets" ] "en" => array:11 [ "idiomaDefecto" => true "titulo" => "Infectious endocarditis" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "383" "paginaFinal" => "388" ] ] "autores" => array:1 [ 0 => array:3 [ "autoresLista" => "A Carceller" "autores" => array:1 [ 0 => array:3 [ "Iniciales" => "A" "apellidos" => "Carceller" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] ] ] ] "afiliaciones" => array:1 [ 0 => array:3 [ "entidad" => "Department of Pediatrics. CHU Sainte-Justine. Université de Montréal. Montréal. Canada." "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Endocarditis infecciosa" ] ] "textoCompleto" => "<p class="elsevierStylePara"><span class="elsevierStyleBold">Why the Tenth Symphony of Gustav Mahler was Unfinished?</span></p><p class="elsevierStylePara"><span class="elsevierStyleItalic">Gustav Mahler <span class="elsevierStyleSup">1,2</span> was born on July 7, 1860, in Kalista (Bohemia) near Moravia. His first musical work was a polka composed at the age of 6 years. Mahler studied music at the Vienna Conservatory. He was a composer much criticized by the press. In 1902, Mahler married Alma Schindler, with whom he had 2 daughters, Anna and Maria. The latter died of scarlet fever at the age of only 5. The death of his younger daughter left him depressed; that same year, he discovered he had a heart disease. Forced by a largely anti-Semitic press, he accepted an offer to conduct the Metropolitan Opera in New York in 1907. In 1911, he fell seriously ill with endocarditis. He was attended by Dr. E. Libman who demonstrated the presence of</span> Streptococcus viridans <span class="elsevierStyleItalic">in a large volume (200 ml) of his blood. Mahler was taken to Paris and treated with</span> "Metchnikoff's Bulgarian milk" (Lactobacillus bulgaricus), <span class="elsevierStyleItalic">the probiotics of that era. However, septic abscesses began to appear in other parts of his body. He was taken back to Vienna, and died on May 18, 1911, leaving his Tenth Symphony incomplete.</span></p><p class="elsevierStylePara"><span class="elsevierStyleBold">Introduction</span></p><p class="elsevierStylePara">Infectious endocarditis is a major infection involving the endocardium, particularly the cardiac valves. For a long time, it was called bacterial endocarditis. Actually, in addition to bacteria, infectious endocarditis can be caused by other microbiological agents. Changes in the presentation of this disease are explained by modifications in susceptible populations, predisposing factors, and the evolution of microorganisms. Despite a great deal of progress made in recent decades, the diagnosis and treatment of endocarditis continue to be difficult.</p><p class="elsevierStylePara"><span class="elsevierStyleBold">Historical aspects</span></p><p class="elsevierStylePara">Fernel's <span class="elsevierStyleItalic">Medicini</span> in 1554 was the first book to introduce the term of endocarditis <span class="elsevierStyleSup">3</span>. During the 17<span class="elsevierStyleSup">th</span> and 18<span class="elsevierStyleSup">th</span> centuries, anomalies of the cardiac valves were described during autopsies of these patients <span class="elsevierStyleSup">2</span>. In 1669, Richard Lower in England was the first to diagnose endocarditis of the tricuspid valve. In 1806, Jean Nicolas Corvisart (1755-1821) was probably the first to use the term "vegetations" <span class="elsevierStyleSup">2</span>. In 1816, Théophile Laënnec <span class="elsevierStyleSup">1</span> invented the cylindrical stethoscope, improving cardiac auscultation. In 1835, Jean-Baptiste Bouillaud <span class="elsevierStyleSup">2</span> defined the endocardium in his "<span class="elsevierStyleItalic">Traité clinique des maladies du coeur</span>". In France, routine blood cultures were introduced by Pasteur in the late 19<span class="elsevierStyleSup">th</span> century <span class="elsevierStyleSup">1</span>. Penicillin was discovered by Sir Alexander Fleming in 1929 and it has being administered for the treatment of this disease since 1940 <span class="elsevierStyleSup"> 2</span>.</p><p class="elsevierStylePara"><span class="elsevierStyleBold">Epidemiology</span></p><p class="elsevierStylePara">Currently, the incidence of endocarditis is 1-4 cases/100,000 or 1/1,300 annual paediatric admissions <span class="elsevierStyleSup">4,5</span>. The increased occurrence of endocarditis is related to improved survival of children with congenital heart disease, newborns or other very ill children. Vascular conduits, patches or valvuloplasty in children with congenital heart disease are risk factors for endocarditis <span class="elsevierStyleSup"> 6</span>. Other risks are: catheter use in critically ill children, children with immunodeficiency, and the neonatology and the paediatric intensive care units <span class="elsevierStyleSup">7</span>. Eight to 10 percent of paediatric infectious endocarditis cases occur in healthy hearts. Endocarditis caused by intravenous drug use is rare in paediatrics. In the past, rheumatic fever was a risk factor, but it has disappeared in the western world. The epidemiology of endocarditis also has changed, thanks to the development and evolution of paediatric cardiology.</p><p class="elsevierStylePara"><span class="elsevierStyleBold">Pathogenesis</span></p><p class="elsevierStylePara">An injury in the endotelium is the first inducer of thrombogenesis <span class="elsevierStyleSup">4</span>, allowing bacteria to adhere and form vegetation. In children with cardiac malformations and turbulent or abnormal blood flow, injuries to the endothelium can easily arise. Catheters traumatize the endocardium <span class="elsevierStyleSup">8</span>. Cutaneous or mucosal injuries from tracheal suction, parenteral feeding and umbilical or peripheral catheters are at the origins of bacteraemia in newborns <span class="elsevierStyleSup"> 4</span>. Neonatal endocarditis frequently affects the right heart of newborns. If there is a critical mass of bacteria in the blood during bacteraemia, they can propagate and adhere to the endocardium. During thrombogenesis, blood platelets, sanguinous fibrin and blood cells collect as deposits, and an aseptic thrombus is formed. Bacteria colonize the aseptic thrombus, and blood platelets, fibrin and blood cells are deposited over these organisms, creating vegetation. Microorganisms trapped in the vegetation are protected from phagocytes and other defence mechanisms <span class="elsevierStyleSup">4</span>.</p><p class="elsevierStylePara"><span class="elsevierStyleBold">Clinical manifestations</span></p><p class="elsevierStylePara">The presentation can be insidious with prolonged fever and non-specific symptoms: fatigue, weakness, anorexia, weight loss, and sweating. At other times, it can be sudden, and these children are terribly ill. Endocarditis presents 4 phenomena:</p><p class="elsevierStylePara"><span class="elsevierStyleItalic"> 1.</span>Bacteraemia or fungemia.</p><p class="elsevierStylePara"><span class="elsevierStyleItalic"> 2.</span>Valvulitis: new heart murmur or cardiac insufficiency.</p><p class="elsevierStylePara"><span class="elsevierStyleItalic"> 3.</span>Immunological responses, much less frequent in children than in adults: petechias, haemorrhages, injuries of Roth or Janeway, Osler nodules or splenomegaly.</p><p class="elsevierStylePara"><span class="elsevierStyleItalic"> 4.</span>Embolic phenomena may involve the kidneys, abdominal viscera, brain or heart.</p><p class="elsevierStylePara">In newborns, the presentation is non-specific. Septic emboli are frequent, causing: osteomyelitis, meningitis or pneumonia <span class="elsevierStyleSup">4</span>.</p><p class="elsevierStylePara"><span class="elsevierStyleBold">Etiology and Laboratory data</span></p><p class="elsevierStylePara">Blood culture is indicated in all children with fever of unknown origin, pathological murmur, a history of cardiac malformation or antecedents of endocarditis. During endocarditis, bacteraemia is continuous; therefore, blood cultures can be done at any time <span class="elsevierStyleSup"> 9</span>. It is important to collect an adequate amount of blood; in small children, this can vary from 1 to 3 ml, and in older children, 5-7 ml. Three blood cultures <span class="elsevierStyleSup">4,5</span> detect more than 95 % of endocarditis in children not exposed to antibiotics, and 90 % in children who have received antibiotics <span class="elsevierStyleSup"> 10-13</span>.</p><p class="elsevierStylePara">Most agents which cause endocarditis are gram-positive cocci <span class="elsevierStyleSup">14</span>: <span class="elsevierStyleItalic"> Streptococci</span>, <span class="elsevierStyleItalic">Staphylococci</span>, <span class="elsevierStyleItalic">Enterococci</span>. The organisms most frequently detected in infectious endocarditis are the <span class="elsevierStyleItalic">S. viridans</span> and the <span class="elsevierStyleItalic">S. aureus</span><span class="elsevierStyleSup">4</span>. In endocarditis caused by catheters, the <span class="elsevierStyleItalic"> S. aureus</span> and the <span class="elsevierStyleItalic">Staphylococci</span> coagulase-negative are frequent. In addition to those 2 agents, it is necessary in newborns to include the presence of <span class="elsevierStyleItalic">Candida</span>, <span class="elsevierStyleItalic">Klebsiella</span> and <span class="elsevierStyleItalic">Enterobacter</span><span class="elsevierStyleSup">14</span>. The organisms classified as the HACEK group are less frequently found at a paediatric age: <span class="elsevierStyleItalic">Haemophilus parainfluenzae</span>, <span class="elsevierStyleItalic">H. aphrophilus</span>, <span class="elsevierStyleItalic">H. paraphrophilus</span>, <span class="elsevierStyleItalic">H. influenzae</span>, <span class="elsevierStyleItalic">Actinobacillus actinomycetemcomitans</span>, <span class="elsevierStyleItalic">Cardiobacterium hominis</span>, <span class="elsevierStyleItalic">Eikenella corrodens, Kingella Kingae</span> and <span class="elsevierStyleItalic">K. denitrificans</span><span class="elsevierStyleSup">4</span>. Fungi are represented by <span class="elsevierStyleItalic">Candida</span> and <span class="elsevierStyleItalic"> Aspergillum</span>. Mylonakis et al <span class="elsevierStyleSup">15</span> enumerated the percentage of microbiological agents detected according to patient age (table 1).</p><p class="elsevierStylePara"><img src="37v63n05-13080399tab01.gif"></img></p><p class="elsevierStylePara">Endocarditis is diagnosed despite negative blood culture if clinical symptoms and heart ultrasound show evident signs of infection. The incidence of negative blood culture is approximately 5-7 %, mostly occurring in patients taking antibiotics or in endocarditis produced by pathogens other than bacteria <span class="elsevierStyleSup">4,16</span>. Vegetation culture can help in the diagnosis <span class="elsevierStyleSup">16</span>. Other laboratory results are non-specific: anaemia, leucocytosis, abnormal sedimentation rate, protein C-reactivity, hyper-gammaglobulinaemia, haematuria, proteinuria.</p><p class="elsevierStylePara"><span class="elsevierStyleBold"> Echocardiography</span></p><p class="elsevierStylePara">For more than 15 years, heart ultrasound has been revolutionizing the diagnosis of endocarditis. This technique visualizes the place of infection, the vegetation, the extent of injury to the valves, and cardiac function. It also evaluates disease severity and influences medical or surgical treatment decisions. Doppler ultrasound allows the diagnosis of stenosis and valve insufficiency. Transthoracic echocardiography, with a sensitivity of 81 %, is very helpful in the diagnosis of paediatric endocarditis <span class="elsevierStyleSup">16</span>. Transoesophagic echocardiograpahy is employed less often in children, and frequently if transthoracic echocardiography is incapable of detecting vegetation <span class="elsevierStyleSup">17-19</span>. However, the absence of vegetation does not exclude the diagnosis of endocarditis. Endocarditis affects the valves, but it can also be located in a defect of the septum, the tendinous cords or wall of the endocardium.</p><p class="elsevierStylePara">The diagnosis of endocarditis is difficult <span class="elsevierStyleSup">20</span> as its clinical manifestations are numerous and non-specific. This explains why the differential diagnosis of endocarditis is important. Considering the consequences of misdiagnosed endocarditis, false-positives do occur. In countries with high immigration rates, it is necessary to remember that recurrence of rheumatic fever can present with the same clinics as endocarditis <span class="elsevierStyleSup">21,22</span>. Echocardiography in conjunction with clinical suspicion is the best criterion for the diagnosis of endocarditis.</p><p class="elsevierStylePara"><span class="elsevierStyleBold">Criteria for diagnosis</span></p><p class="elsevierStylePara">In 1909, Sir Thomas Horder <span class="elsevierStyleSup">1</span> from England described the first criteria for diagnosis: the signs and symptoms of endocarditis. Throughout the 20<span class="elsevierStyleSup">th</span> century, these criteria have undergone various modifications. In 1981, Von Reyn et al <span class="elsevierStyleSup">23</span> (table 2) proposed criteria to facilitate the diagnosis of the disease. These authors presented 123 adults treated at the Beth Israel Hospital in Boston and classified endocarditis as: definitive, probable, possible, or rejected. In 1994, at Duke University in North Carolina, Durack et al <span class="elsevierStyleSup">24</span> (tables 2 and 3) proposed new diagnostic criteria with the introduction of echocardiography: definitive, possible or rejected endocarditis. According to the criteria of Durack <span class="elsevierStyleSup">24</span> et al, any case of endocarditis not rejected must be considered possible. These criteria seem to present good sensitivity, but are non-specific. In 2000, Li et al <span class="elsevierStyleSup">25</span> (tables 2 and 3) tried to be stricter in endocarditis diagnosis and modified the earlier criteria of Durack <span class="elsevierStyleSup">24</span> et al.</p><p class="elsevierStylePara"><img src="37v63n05-13080399tab02.gif"></img></p><p class="elsevierStylePara"><img src="37v63n05-13080399tab03.gif"></img></p><p class="elsevierStylePara">The above-mentioned diagnostic criteria have been validated for use in adult cardiology <span class="elsevierStyleSup">26</span>. Some authors have tried to validate these criteria in paediatric cardiology <span class="elsevierStyleSup">27-29</span>. However, infectious endocarditis is a disease with a very variable clinical presentation. Isolated criteria are not sufficient to make a diagnosis. The various criteria are clinical guides to help in the diagnosis, but they do not replace clinical judgement. Molecular diagnosis can be helpful in cases with negative blood culture <span class="elsevierStyleSup"> 30</span>. Echocardiography also has been very useful. In the paediatric population, transthoracic echocardiography gives considerable information; transoesophagic echocardiography is rarely necesary <span class="elsevierStyleSup">17-19</span>. Echocardiography is not indicated if there is no clinical evidence to support the diagnosis of endocarditis. Each patient with suspicion of endocarditis deserves critical evaluation, to improve the clinical-microbiological diagnosis and treatment <span class="elsevierStyleSup">31</span>.</p><p class="elsevierStylePara"><span class="elsevierStyleBold">Treatment</span></p><p class="elsevierStylePara">In general, treatment is given for 4 weeks, but is extended up to 6 weeks if the symptoms of presentation have lasted more than 3 months (table 4) <span class="elsevierStyleSup">4,6,15,32</span>. Treatment is initiated in the hospital, but in some cases, it is complemented with antibiotic therapy at home.</p><p class="elsevierStylePara"><img src="37v63n05-13080399tab04.gif"></img></p><p class="elsevierStylePara"><span class="elsevierStyleBold">Complications and outcome</span></p><p class="elsevierStylePara">The clinical situations that favour complications <span class="elsevierStyleSup">4,31,32</span> and surgical indications according to the anomalies found at echocardiography are listed in table 5. Coward et al <span class="elsevierStyleSup">33</span> reported a 49 % incidence of complications. Mylonakis et al <span class="elsevierStyleSup"> 15</span> found 20-25 % adult mortality secondary to endocarditis. Danilowicz <span class="elsevierStyleSup">6</span> recorded a 20-30 % incidence of mortality in paediatric age patients, but recently some authors <span class="elsevierStyleSup">33</span> have determined the incidence to be 12 %.</p><p class="elsevierStylePara"><img src="37v63n05-13080399tab05.gif"></img></p><p class="elsevierStylePara"><span class="elsevierStyleBold">Prevention</span></p><p class="elsevierStylePara">The indications and doses of antibiotics to prevent infectious endocarditis are listed in table 6 <span class="elsevierStyleSup">4-6,34-38</span>.</p><p class="elsevierStylePara"><img src="37v63n05-13080399tab06.gif"></img></p><p class="elsevierStylePara"><span class="elsevierStyleBold">Conclusion</span></p><p class="elsevierStylePara"><span class="elsevierStyleItalic"> 1.</span>Paediatric infectious endocarditis is rare, but its incidence has risen owing to the survival of children with operated congenital heart disease.</p><p class="elsevierStylePara"><span class="elsevierStyleItalic"> 2.</span>In recent decades, the paediatric population at risk of endocarditis has changed, given the increase of children with immunodeficiency disease and children under neonatal and paediatric intensive care.</p><p class="elsevierStylePara"><span class="elsevierStyleItalic"> 3.</span>Infectious endocarditis in healthy children is rare but not exceptional.</p><p class="elsevierStylePara"><span class="elsevierStyleItalic"> 4.</span>Complications continue to be frequent.</p><p class="elsevierStylePara"><span class="elsevierStyleItalic"> 5.</span>Diagnostic criteria are guidelines that do not replace clinical judgement.</p>" "pdfFichero" => "37v63n05a13080399pdf001.pdf" "tienePdf" => true "multimedia" => array:6 [ 0 => array:8 [ "identificador" => "tbl1" "etiqueta" => "TABLE 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "copyright" => "Elsevier España" "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:1 [ "tablaImagen" => array:1 [ 0 => array:4 [ "imagenFichero" => "37v63n05-13080399tab01.gif" "imagenAlto" => 769 "imagenAncho" => 924 "imagenTamanyo" => 43070 ] ] ] ] ] "descripcion" => array:1 [ "en" => "Pathogens causing endocarditis according to age" ] ] 1 => array:8 [ "identificador" => "tbl2" "etiqueta" => "TABLE 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "copyright" => "Elsevier España" "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:1 [ "tablaImagen" => array:1 [ 0 => array:4 [ "imagenFichero" => "37v63n05-13080399tab02.gif" "imagenAlto" => 1440 "imagenAncho" => 1583 "imagenTamanyo" => 130307 ] ] ] ] ] "descripcion" => array:1 [ "en" => "Criteria for diagnosis" ] ] 2 => array:8 [ "identificador" => "tbl3" "etiqueta" => "TABLE 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "copyright" => "Elsevier España" "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:1 [ "tablaImagen" => array:1 [ 0 => array:4 [ "imagenFichero" => "37v63n05-13080399tab03.gif" "imagenAlto" => 1441 "imagenAncho" => 1572 "imagenTamanyo" => 140638 ] ] ] ] ] "descripcion" => array:1 [ "en" => "Criteria for diagnosis" ] ] 3 => array:8 [ "identificador" => "tbl4" "etiqueta" => "TABLE 4" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "copyright" => "Elsevier España" "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:1 [ "tablaImagen" => array:1 [ 0 => array:4 [ "imagenFichero" => "37v63n05-13080399tab04.gif" "imagenAlto" => 818 "imagenAncho" => 907 "imagenTamanyo" => 45814 ] ] ] ] ] "descripcion" => array:1 [ "en" => "Therapy of Infectious Endocarditis 4,6" ] ] 4 => array:8 [ "identificador" => "tbl5" "etiqueta" => "TABLE 5" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "copyright" => "Elsevier España" "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:1 [ "tablaImagen" => array:1 [ 0 => array:4 [ "imagenFichero" => "37v63n05-13080399tab05.gif" "imagenAlto" => 1562 "imagenAncho" => 909 "imagenTamanyo" => 83015 ] ] ] ] ] "descripcion" => array:1 [ "en" => "Risk for complications" ] ] 5 => array:8 [ "identificador" => "tbl6" "etiqueta" => "TABLE 6" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "copyright" => "Elsevier España" "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:1 [ "tablaImagen" => array:1 [ 0 => array:4 [ "imagenFichero" => "37v63n05-13080399tab06.gif" "imagenAlto" => 2236 "imagenAncho" => 909 "imagenTamanyo" => 151879 ] ] ] ] ] "descripcion" => array:1 [ "en" => "Prophylaxis of endocarditis" ] ] ] "bibliografia" => array:2 [ "titulo" => "Bibliography" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:38 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "referenciaCompleta" => "Emerging issues in infective endocarditis. Emerging Infectious Diseases. 2004;10:1110-6. Available at: www.cdc.gov/eid" "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Emerging issues in infective endocarditis. Emerging Infectious Diseases. 2004;10:1110-6. Available at: www.cdc.gov/eid" "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "Millar BC" 1 => "Moore JE." ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Towards a history of infective endocarditis." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "Contrepois A." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Medical History" "fecha" => "1996" "volumen" => "40" "paginaInicial" => "25" "paginaFinal" => "54" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8824676" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib3" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Profiles in Cardiology." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "Fye WB" 1 => "Fernel JF." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Clin Cardiol" "fecha" => "1997" "volumen" => "20" "paginaInicial" => "1037" "paginaFinal" => "8" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9422845" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib4" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Unique features of infective endocarditis in childhood." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:7 [ 0 => "Ferrieri P" 1 => "Gewitz MH" 2 => "Gerber MA" 3 => "Newburger JW" 4 => "Dajani AS" 5 => "Shulman ST" 6 => "et al." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Pediatrics" "fecha" => "2002" "volumen" => "109" "paginaInicial" => "931" "paginaFinal" => "43" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11986458" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib5" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Pediatric bacterial endocarditis. Treatment and prophylaxis." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "Brook MM." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Pediatr Clin North Am" "fecha" => "1999" "volumen" => "46" "paginaInicial" => "275" "paginaFinal" => "87" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10218075" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib6" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Infective endocarditis." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "Danilowicz D." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Pediatr Rev" "fecha" => "1995" "volumen" => "16" "paginaInicial" => "148" "paginaFinal" => "54" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7731910" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib7" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Changing risk factors for pediatric infective endocarditis." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "Fisher MC." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Curr Infect Dis Reports" "fecha" => "2001" "volumen" => "3" "paginaInicial" => "333" "paginaFinal" => "6" ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib8" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "The changing spectrum of neonatal endocarditis." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "Millard DD" 1 => "Shulman ST." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Clin Perinatol" "fecha" => "1988" "volumen" => "15" "paginaInicial" => "587" "paginaFinal" => "608" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3066553" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib9" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Studies on the bacteriemia of bacterial endocarditis." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "Werner AS" 1 => "Cobbs CG" 2 => "Kaye D" 3 => "Hook EW." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "JAMA" "fecha" => "1967" "volumen" => "202" "paginaInicial" => "199" "paginaFinal" => "203" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/4860941" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib10" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Endocarditis in the pediatric population." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "Stock JH" 1 => "Sahn DJ." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Curr Treat Op Cardiovasc Med" "fecha" => "2000" "volumen" => "2" "paginaInicial" => "481" "paginaFinal" => "8" ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib11" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Infective endocarditis: 35 years of experience at a Children's Hospital." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "Martin JM" 1 => "Neches WH" 2 => "Wald ET." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Clin Infect Dis" "fecha" => "1997" "volumen" => "24" "paginaInicial" => "669" "paginaFinal" => "75" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9145742" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib12" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Infective endocarditis in children." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "Baltimore RS." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Pediatr Infect Dis J" "fecha" => "1992" "volumen" => "11" "paginaInicial" => "907" "paginaFinal" => "13" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1454430" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib13" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Microbiological recommendations for the diagnosis and follow-up of infective endocarditis." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "Gutschik E." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Clin Microbiol Infect" "fecha" => "1998" "volumen" => "4" "paginaInicial" => "S10" "paginaFinal" => "6" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11869258" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib14" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Bacterial endocarditis in infants and children. Review." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "Milazzo AS" 1 => "Li JS." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Pediatr Infect Dis J" "fecha" => "2001" "volumen" => "20" "paginaInicial" => "799" "paginaFinal" => "801" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11734744" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib15" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Infective endocarditis in adults." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "Mylonakis E" 1 => "Calderwood SB." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJMra010082" "Revista" => array:6 [ "tituloSerie" => "N Engl J Med" "fecha" => "2001" "volumen" => "345" "paginaInicial" => "1318" "paginaFinal" => "30" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11794152" "web" => "Medline" ] ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib16" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "referenciaCompleta" => "Infections of the heart. In: Wright, editor. Microbiology and clinical practice. 2nd ed. Toronto, 1989. p. 413-27." "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Infections of the heart. In: Wright, editor. Microbiology and clinical practice. 2nd ed. Toronto, 1989. p. 413-27." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "Shanson DC." ] ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib17" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Clinical utility of two-dimensional echocardiography in infective endocarditis." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "Martin RP" 1 => "Meltzer RS" 2 => "Chia BL" 3 => "Stinson EB" 4 => "Popp RL." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Am J Cardiol" "fecha" => "1980" "volumen" => "46" "paginaInicial" => "379" "paginaFinal" => "85" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7415982" "web" => "Medline" ] ] ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib18" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "The relative roles of transthoracic compared with transesophageal echocardiography in children with suspected infective endocarditis." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "Humpl T" 1 => "McCrindle BW" 2 => "Smallhorn JF." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Am Coll Cardiol" "fecha" => "2003" "volumen" => "41" "paginaInicial" => "2068" "paginaFinal" => "71" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12798583" "web" => "Medline" ] ] ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib19" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Indications and guidelines for performance of Transesophageal echocardiography in the patient with pediatric acquired or congenital heart disease." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:7 [ 0 => "Ayres NA" 1 => "Miller-Hance W" 2 => "Fyfe DA" 3 => "Stevenson JG" 4 => "Sahn DJ" 5 => "Young LT" 6 => "et al." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.echo.2004.11.004" "Revista" => array:6 [ "tituloSerie" => "J Am Soc Echocardiogr" "fecha" => "2005" "volumen" => "18" "paginaInicial" => "91" "paginaFinal" => "8" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15637497" "web" => "Medline" ] ] ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib20" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "The role of transthoracic echocardiography in the diagnosis of infective endocarditis in children." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "Aly AM" 1 => "Simpson PM" 2 => "Humes RA." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Arch Pediatr Adolesc Med" "fecha" => "1999" "volumen" => "153" "paginaInicial" => "950" "paginaFinal" => "4" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10482211" "web" => "Medline" ] ] ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib21" "etiqueta" => "21" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Diagnosis of infective endocarditis." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "Lukes AS" 1 => "Bright DK" 2 => "Durack DT." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Infect Dis Clin North Am" "fecha" => "1993" "volumen" => "7" "paginaInicial" => "1" "paginaFinal" => "8" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8463647" "web" => "Medline" ] ] ] ] ] ] ] ] 21 => array:3 [ "identificador" => "bib22" "etiqueta" => "22" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:1 [ "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "Kadir IS" 1 => "Barker TA" 2 => "Clarke B" 3 => "Denley H" 4 => "Grötte GJ." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Recurrent acute rheumatic fever:A forgotten diagnosis? Ann Thorac Surg" "fecha" => "2004" "volumen" => "78" "paginaInicial" => "699" "paginaFinal" => "701" ] ] ] ] ] ] 22 => array:3 [ "identificador" => "bib23" "etiqueta" => "23" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Infective endocarditis: an analysis based on strict case definitions." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "Von Reyn CF" 1 => "Levy BS" 2 => "Arbeit RD" 3 => "Friedland G" 4 => "Crumpacker CS." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Ann Intern Med" "fecha" => "1981" "volumen" => "94" "paginaInicial" => "505" "paginaFinal" => "18" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7011141" "web" => "Medline" ] ] ] ] ] ] ] ] 23 => array:3 [ "identificador" => "bib24" "etiqueta" => "24" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "New Criteria for diagnosis of infective endocarditis: utilization of specific echocardiographic findings." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "Durack DT" 1 => "Lukes AS" 2 => "Bright DK." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Am J Med" "fecha" => "1994" "volumen" => "96" "paginaInicial" => "200" "paginaFinal" => "9" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8154507" "web" => "Medline" ] ] ] ] ] ] ] ] 24 => array:3 [ "identificador" => "bib25" "etiqueta" => "25" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Proposed modifications to the Duke Criteria for the diagnosis of infective endocarditis." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:7 [ 0 => "Li JS" 1 => "Sexton DJ" 2 => "Mick N" 3 => "Nettles R" 4 => "Fowler VG" 5 => "Ryan T" 6 => "et al." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1086/313753" "Revista" => array:6 [ "tituloSerie" => "Clin Infect Dis" "fecha" => "2000" "volumen" => "30" "paginaInicial" => "633" "paginaFinal" => "8" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10770721" "web" => "Medline" ] ] ] ] ] ] ] ] 25 => array:3 [ "identificador" => "bib26" "etiqueta" => "26" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Individual value of each of the Duke Criteria for the diagnosis of infective endocarditis." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "Rognon R" 1 => "Kehtari R." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Clin Microbiol Infect" "fecha" => "1999" "volumen" => "5" "paginaInicial" => "396" "paginaFinal" => "403" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11853564" "web" => "Medline" ] ] ] ] ] ] ] ] 26 => array:3 [ "identificador" => "bib27" "etiqueta" => "27" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:1 [ "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:7 [ 0 => "Stockheim JA" 1 => "Chadwick EG" 2 => "Kessler S" 3 => "Amer M" 4 => "Abdel-Haq N" 5 => "Dajani AS" 6 => "et al." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Are the Duke criteria superior to the Beth Israel Criteria for the diagnosis of infective endocarditis in children? Clin Infect Dis" "fecha" => "1998" "volumen" => "27" "paginaInicial" => "1451" "paginaFinal" => "6" ] ] ] ] ] ] 27 => array:3 [ "identificador" => "bib28" "etiqueta" => "28" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Infective endocarditis in children: clinical analyzes and evaluation of two diagnostic criteria." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:7 [ 0 => "Marco del Pont J" 1 => "De Dicco LT" 2 => "Vartalitis C" 3 => "Ithurralde M" 4 => "Gallo JP" 5 => "Vargas F" 6 => "et al." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Pediatr Infect Dis J" "fecha" => "1995" "volumen" => "14" "paginaInicial" => "1079" "paginaFinal" => "86" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8745022" "web" => "Medline" ] ] ] ] ] ] ] ] 28 => array:3 [ "identificador" => "bib29" "etiqueta" => "29" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Value and limitations of the von Reyn, Duke and modified Duke Criteria for the diagnosis of infective endocarditis in children." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "Tissières P" 1 => "Gervaix A" 2 => "Beghetti M" 3 => "Jaeggi ET." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Pediatrics" "fecha" => "2003" "volumen" => "112" "paginaInicial" => "e467" "paginaFinal" => "e71" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14654647" "web" => "Medline" ] ] ] ] ] ] ] ] 29 => array:3 [ "identificador" => "bib30" "etiqueta" => "30" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Current trends in the molecular diagnosis of infective endocarditis." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "Millar BC" 1 => "Moore JE." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Europ J Clin Microbiol & Infect Dis" "fecha" => "2004" "volumen" => "23" "paginaInicial" => "353" "paginaFinal" => "65" ] ] ] ] ] ] 30 => array:3 [ "identificador" => "bib31" "etiqueta" => "31" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Diagnosis and management of infective endocarditis and its complications." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:7 [ 0 => "Bayer A" 1 => "Bolger A" 2 => "Taubert K" 3 => "Wilson W" 4 => "Steckelberg J" 5 => "Karchmer AW" 6 => "et al." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Circulation" "fecha" => "1998" "volumen" => "98" "paginaInicial" => "2936" "paginaFinal" => "48" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9860802" "web" => "Medline" ] ] ] ] ] ] ] ] 31 => array:3 [ "identificador" => "bib32" "etiqueta" => "32" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Recent trends in infective endocarditis: Influence of case definitions." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "Devlin RK" 1 => "Andrews MM" 2 => "Von Reyn CF." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Curr Op Cardiol" "fecha" => "2004" "volumen" => "19" "paginaInicial" => "134" "paginaFinal" => "9" ] ] ] ] ] ] 32 => array:3 [ "identificador" => "bib33" "etiqueta" => "33" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Infective endocarditis in Arkansan children from 1990 through 2002." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "Coward K" 1 => "Tucker N" 2 => "Darville T." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/01.inf.0000101186.88472.b5" "Revista" => array:6 [ "tituloSerie" => "Pediatr Infect Dis J" "fecha" => "2003" "volumen" => "22" "paginaInicial" => "1048" "paginaFinal" => "52" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14688563" "web" => "Medline" ] ] ] ] ] ] ] ] 33 => array:3 [ "identificador" => "bib34" "etiqueta" => "34" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Guidelines on Prevention, Diagnosis and treatment of infective endocarditis." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "Horstkotte D and the Task Force on Infective Endocarditis of the European Society of Cardiology." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ehj.2003.11.008" "Revista" => array:6 [ "tituloSerie" => "Eur Heart J" "fecha" => "2004" "volumen" => "25" "paginaInicial" => "267" "paginaFinal" => "76" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14972429" "web" => "Medline" ] ] ] ] ] ] ] ] 34 => array:3 [ "identificador" => "bib35" "etiqueta" => "35" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:1 [ "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "Oliver R" 1 => "Roberts GJ" 2 => "Hooper L." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:3 [ "tituloSerie" => "Penicillins for the prophylaxis of bacterial endocarditis in dentistry [Review]. The Cochrane Database Syst Re" "fecha" => "2004" "paginaInicial" => "CD003813" ] ] ] ] ] ] 35 => array:3 [ "identificador" => "bib36" "etiqueta" => "36" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Prevention of infective endocarditis." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "Durack DT." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJM199501053320107" "Revista" => array:7 [ "tituloSerie" => "N Engl J Med" "fecha" => "1995" "volumen" => "332" "paginaInicial" => "38" "paginaFinal" => "44" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7990863" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0163445311000211" "estado" => "S300" "issn" => "01634453" ] ] ] ] ] ] ] 36 => array:3 [ "identificador" => "bib37" "etiqueta" => "37" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Prevention of bacterial endocarditis. Recommendations by the American Heart Association." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:7 [ 0 => "Dajani AS" 1 => "Taubert KA" 2 => "Wilson W" 3 => "Bolger AF" 4 => "Bayer A" 5 => "Ferrieri P" 6 => "et al." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "JAMA" "fecha" => "1997" "volumen" => "277" "paginaInicial" => "1794" "paginaFinal" => "801" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9178793" "web" => "Medline" ] ] ] ] ] ] ] ] 37 => array:3 [ "identificador" => "bib38" "etiqueta" => "38" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Infective endocarditis. Diagnosis, antimicrobial therapy and management of complications." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "Baddour LM" 1 => "Wilson WR" 2 => "Bayer AS" 3 => "Fowler VG" 4 => "Bolger AF" 5 => "Levison ME." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1161/CIRCULATIONAHA.105.165564" "Revista" => array:6 [ "tituloSerie" => "Circulation" "fecha" => "2005" "volumen" => "111" "paginaInicial" => "e394" "paginaFinal" => "e434" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15956145" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/16954033/0000006300000005/v0_201404151137/13080399/v0_201404151137/en/main.assets" "Apartado" => array:4 [ "identificador" => "14281" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Editorial" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/16954033/0000006300000005/v0_201404151137/13080399/v0_201404151137/en/37v63n05a13080399pdf001.pdf?idApp=UINPBA00005H&text.app=https://analesdepediatria.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/13080399?idApp=UINPBA00005H" ]
Información del artículo
ISSN: 16954033Idioma original: Inglés
Datos actualizados diariamente
| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 9 | 20 | 29 |
| 2024 Octubre | 69 | 87 | 156 |
| 2024 Septiembre | 72 | 61 | 133 |
| 2024 Agosto | 98 | 82 | 180 |
| 2024 Julio | 80 | 78 | 158 |
| 2024 Junio | 108 | 74 | 182 |
| 2024 Mayo | 88 | 77 | 165 |
| 2024 Abril | 97 | 93 | 190 |
| 2024 Marzo | 115 | 76 | 191 |
| 2024 Febrero | 155 | 80 | 235 |
| 2024 Enero | 160 | 79 | 239 |
| 2023 Diciembre | 232 | 74 | 306 |
| 2023 Noviembre | 271 | 98 | 369 |
| 2023 Octubre | 250 | 99 | 349 |
| 2023 Septiembre | 160 | 62 | 222 |
| 2023 Agosto | 119 | 60 | 179 |
| 2023 Julio | 136 | 72 | 208 |
| 2023 Junio | 120 | 83 | 203 |
| 2023 Mayo | 216 | 94 | 310 |
| 2023 Abril | 99 | 87 | 186 |
| 2023 Marzo | 137 | 95 | 232 |
| 2023 Febrero | 125 | 51 | 176 |
| 2023 Enero | 118 | 79 | 197 |
| 2022 Diciembre | 137 | 84 | 221 |
| 2022 Noviembre | 161 | 71 | 232 |
| 2022 Octubre | 152 | 109 | 261 |
| 2022 Septiembre | 175 | 76 | 251 |
| 2022 Agosto | 224 | 73 | 297 |
| 2022 Julio | 170 | 85 | 255 |
| 2022 Junio | 128 | 70 | 198 |
| 2022 Mayo | 156 | 102 | 258 |
| 2022 Abril | 199 | 92 | 291 |
| 2022 Marzo | 155 | 84 | 239 |
| 2022 Febrero | 167 | 102 | 269 |
| 2022 Enero | 192 | 100 | 292 |
| 2021 Diciembre | 112 | 105 | 217 |
| 2021 Noviembre | 100 | 102 | 202 |
| 2021 Octubre | 121 | 90 | 211 |
| 2021 Septiembre | 101 | 90 | 191 |
| 2021 Agosto | 99 | 83 | 182 |
| 2021 Julio | 85 | 83 | 168 |
| 2021 Junio | 91 | 96 | 187 |
| 2021 Mayo | 78 | 68 | 146 |
| 2021 Abril | 255 | 139 | 394 |
| 2021 Marzo | 227 | 105 | 332 |
| 2021 Febrero | 127 | 44 | 171 |
| 2021 Enero | 93 | 37 | 130 |
| 2020 Diciembre | 122 | 37 | 159 |
| 2020 Noviembre | 96 | 33 | 129 |
| 2020 Octubre | 79 | 22 | 101 |
| 2020 Septiembre | 38 | 11 | 49 |
| 2020 Agosto | 70 | 27 | 97 |
| 2020 Julio | 71 | 14 | 85 |
| 2020 Junio | 66 | 21 | 87 |
| 2020 Mayo | 90 | 19 | 109 |
| 2020 Abril | 49 | 18 | 67 |
| 2020 Marzo | 59 | 16 | 75 |
| 2020 Febrero | 47 | 16 | 63 |
| 2020 Enero | 48 | 18 | 66 |
| 2019 Diciembre | 55 | 25 | 80 |
| 2019 Noviembre | 47 | 14 | 61 |
| 2019 Octubre | 51 | 11 | 62 |
| 2019 Septiembre | 30 | 15 | 45 |
| 2019 Agosto | 30 | 15 | 45 |
| 2019 Julio | 37 | 16 | 53 |
| 2019 Junio | 69 | 24 | 93 |
| 2019 Mayo | 112 | 29 | 141 |
| 2019 Abril | 122 | 21 | 143 |
| 2019 Marzo | 40 | 20 | 60 |
| 2019 Febrero | 31 | 9 | 40 |
| 2019 Enero | 46 | 19 | 65 |
| 2018 Diciembre | 52 | 24 | 76 |
| 2018 Noviembre | 60 | 30 | 90 |
| 2018 Octubre | 83 | 14 | 97 |
| 2018 Septiembre | 34 | 12 | 46 |
| 2018 Agosto | 5 | 0 | 5 |
| 2018 Julio | 9 | 0 | 9 |
| 2018 Junio | 5 | 0 | 5 |
| 2018 Mayo | 10 | 0 | 10 |
| 2018 Abril | 55 | 0 | 55 |
| 2018 Marzo | 35 | 0 | 35 |
| 2018 Febrero | 25 | 0 | 25 |
| 2018 Enero | 30 | 0 | 30 |
| 2017 Diciembre | 32 | 0 | 32 |
| 2017 Noviembre | 32 | 0 | 32 |
| 2017 Octubre | 39 | 0 | 39 |
| 2017 Septiembre | 44 | 0 | 44 |
| 2017 Agosto | 36 | 0 | 36 |
| 2017 Julio | 38 | 2 | 40 |
| 2017 Junio | 48 | 11 | 59 |
| 2017 Mayo | 101 | 18 | 119 |
| 2017 Abril | 39 | 5 | 44 |
| 2017 Marzo | 35 | 7 | 42 |
| 2017 Febrero | 72 | 9 | 81 |
| 2017 Enero | 22 | 7 | 29 |
| 2016 Diciembre | 44 | 15 | 59 |
| 2016 Noviembre | 73 | 8 | 81 |
| 2016 Octubre | 121 | 6 | 127 |
| 2016 Septiembre | 155 | 7 | 162 |
| 2016 Agosto | 21 | 6 | 27 |
| 2016 Julio | 6 | 0 | 6 |
| 2015 Diciembre | 1 | 0 | 1 |
| 2015 Octubre | 1 | 16 | 17 |
| 2015 Septiembre | 9 | 0 | 9 |
| 2015 Agosto | 1 | 11 | 12 |
| 2015 Julio | 10 | 0 | 10 |
| 2015 Junio | 11 | 3 | 14 |
| 2015 Mayo | 18 | 0 | 18 |
| 2015 Abril | 6 | 1 | 7 |
| 2015 Marzo | 16 | 3 | 19 |
| 2015 Febrero | 5 | 3 | 8 |
| 2015 Enero | 14 | 0 | 14 |
| 2014 Diciembre | 11 | 2 | 13 |
| 2014 Noviembre | 6 | 2 | 8 |
| 2014 Octubre | 17 | 2 | 19 |
| 2014 Septiembre | 14 | 0 | 14 |
| 2014 Agosto | 11 | 0 | 11 |
| 2014 Julio | 23 | 1 | 24 |
| 2014 Junio | 62 | 3 | 65 |
| 2014 Mayo | 67 | 5 | 72 |
| 2014 Abril | 65 | 5 | 70 |
| 2014 Marzo | 63 | 14 | 77 |
| 2014 Febrero | 47 | 8 | 55 |
| 2014 Enero | 22 | 8 | 30 |
| 2013 Diciembre | 38 | 6 | 44 |
| 2013 Noviembre | 41 | 7 | 48 |
| 2013 Octubre | 39 | 7 | 46 |
| 2013 Septiembre | 23 | 7 | 30 |
| 2013 Agosto | 28 | 8 | 36 |
| 2013 Julio | 28 | 4 | 32 |
| 2013 Junio | 8 | 4 | 12 |
| 2013 Mayo | 4 | 2 | 6 |
| 2013 Abril | 5 | 1 | 6 |
| 2013 Marzo | 9 | 2 | 11 |
| 2013 Febrero | 19 | 1 | 20 |
| 2013 Enero | 14 | 0 | 14 |
| 2012 Diciembre | 6 | 0 | 6 |
| 2012 Noviembre | 3 | 1 | 4 |
| 2012 Octubre | 2 | 1 | 3 |
| 2012 Septiembre | 2 | 0 | 2 |
| 2005 Noviembre | 1305 | 0 | 1305 |
Mostrar todo
