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Master Thesis

Le parcours pré hospitalier des patients atteints d'une endocardite infectieuse‎ : réflexion sur la place des hémocultures en ambulatoire

Abstract : Method: Retrospective and monocentric study, at Chambery's hospital, between the 1st of Januray 2007 until the 31st December 2011, involving 93 patients hospitalised for a definite or possible infectious endocarditis according to the Duke criteria. Comparison between patients who had blood cultures before hospitalisation, and patients who had not. Results: 54 patients (58%) had been followed in ambulatory by a generalist practicioner, and 9 (17%) had ambulatory blood cultures. Sixty one percent had at leat one risk factor of infective endocarditis, and 21% had blood cultures. Fourty eight percent were at risk and had fever, and 23% had blood cultures. However, only 63% of all patients had fever noticed in ambulatory, and 24% had neither risk facor, nor fever. Ambulatory blood cultures were positive for 8 on the 9 patients, who were hospitalised 48 hours after they were realised, but no significative impact was shown on patient's evolution. Conclusion: Our study shows that ambulatory blood culltures are under prescribed in the diagnosis of infective endocarditits. On the one hand, the diagonsis seems under mentioned, demonstrated by the low number of patients who were at risk and had fever, and who had ambulatory blood cultures.One the other hand, possibility of realising blood cultures in any private laboratory might be still ignored by praticioners. However, the diagnosis of infective endocarditis remains difficult, regard to the non specific and misleading clinical signs. In perspective, an optimisation of ambulatory blood cultures' precriptions, leading to an increase of their realisation, may possibly shows, in larger studies, an improvement on patients'management.
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Submitted on : Monday, April 15, 2013 - 9:10:22 AM
Last modification on : Tuesday, May 11, 2021 - 11:36:16 AM
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Raphaëlle Papillon. Le parcours pré hospitalier des patients atteints d'une endocardite infectieuse‎ : réflexion sur la place des hémocultures en ambulatoire. Médecine humaine et pathologie. 2013. ⟨dumas-00813089⟩

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