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V P Drobysheva

Publications and source records attributed to V P Drobysheva.

7 recordsLinked to original sources
PubMed1991

[The overdiagnosis of bacterial endocarditis].

The diagnosis of bacterial endocarditis (BE) is analyzed in 255 patients. After examination, the diagnosis of BE was verified but in 92 patients (36.1%). Of these, BE was overdiagnosed in 163 patients (63.9%). The main causes of the overdiagnosis were body temperature rise in 134 patients (52.6%), heart murmur in 163 patients (63.9%), and positive hemoculture in 57 patients (22.3%). Three cases of BE overdiagnosis are provided. Exaggeration of the specificity of body temperature rise in patients with heart murmur often leads to BE overdiagnosis. Mitral valve prolapse is one of the predisposing BE factors. At the same time it is a cause of overdiagnosis of BE in patients with fever, BE overdiagnosis often results in unbased long-term antibacterial therapy, while other causes of the symptoms are not considered. Ineffectiveness of antibacterial treatment (no clinical improvement, continuous or recurrent fever) points to the necessity of further diagnostic search.

Adolescent↗
PubMed1991

[Kidney involvement in infectious endocarditis (hematuria)].

As many as 113 patients suffering from infectious endocarditis (IE) were placed under observation. Renal damage was discovered in 28 patients (24.7%). Hematuria was the common laboratory sign of renal damage. 15% of patients showed microhematuria, 9.7 had macrohematuria. In 15% of patients with IE, hematuria was due to diffuse glomerulonephritis, in 5.3% to renal infarction, and in 4.4% to focal glomerulonephritis. In 3.5% of patients, the nephrotic syndrome developed at the disease onset, it was attended by hematuria and was thus a cause of erroneous diagnoses. The appearance of hematuria at the IE onset, attesting to involvement of the kidneys into the pathological process, complicates the diagnosis and early treatment institution. Detection of the hematuric syndrome in patients with a verified diagnosis of IE requires specification of the character of renal damage. The latter one contributes to a graver and prognostically unfavourable course of IE. In 2 out of 8 patients with associated IE and renal damage, the death was caused by progressive chronic renal failure. Postmortem examination confirmed mesangioproliferative glomerulonephritis in all the subjects; in 4, it was coupled with renal infarction. 14.1% of the patients manifested complete and 3.5% partial disappearance of hematuria under the influence of adequate antibacterial therapy of IE.

Adult↗