Cureus om Pathogenesis, Diagnosis, Antimicrobial Therapy, and Management of Infective Endocarditis, and Its Complications Sushi Kamde!, Ait Ajankar? | Pato Javahra Nebr Mel Clee, Dat Meg state Medi Scenes Wah IND 2 Free edn, labial Nets Medel alee, alt Mee neste of Men Sens, rd, IND Conesponding autho Sls ? ade, sashihnde gl con Abstract Infective endocarditis in the adults fe sveatenng Bacal endocarditis a inner nfctin ning the heart muscle endocardium). Te sentie stay of the cases of diseases s known as elo. The agents that cause diene al it ve roupe: bacteria, iss, proto, fang an helminths (worms) Rik factors ae past hear defects, dtnaged or abnormal hear ves, ne valve ater srgery, crane hemodialysis andimmunosupprsse stat chemotherapy, HV, et). Infectiveendocarsseaegorized lntotwo cna forms: bacterial cute and sect endocads, Acie bere endocartes usally, used by taphyococt ph) and sreproccc te). Aad occasional by stra and bel baci ‘tals, lvaive medal tecoogy has inereseed the esponablty of helthcace-sesoatedifsve ‘endocardts(HALE Seoacopy ofthe eae lethe con gressive callin the deeper zone of ‘onspei,composed offs an platelets covet ecionis of bacteria Tuberculous vat ‘docardt ue to mycobacterium taberculae rae clini enti, yphltcendcaris pahologlally the cuaneous sions of secondary syphilis. ts caused by infection with the ‘mlerotganis Treponema plu. Fungal endcads ara and fata condition. They are ected with fag suchas Conia cans Mstplasma capsulatum ard Aspergils species, Fatal endoaris ‘tated wth Q fever (Query eve, fever se cron prolonged dca cased by the iets lke bacle Col bureaus form of nce nthe endocadls alel-nser vit (V2) Infection eautesehoni and repeated feb ness, They are followed bypharyng, sse, anda ‘esiula ash, Conifer sully munifess as endoars or heplts. The therapy vent simply ‘he complications le antnctobia therapy, The medicines pescrbed are ampli, cefzalin, cetandie, ental, vancomyel, mevonidzoe, and webranyeln High meilnal abies ate used conti the spread ofinfectiveendocats. Categories Cert, atopy etre Technology Xeyword:exment managemen oitopic ne, flame beh aetna, ages, polos, eee ences Introduction And Background Infectiv nocariti a potently dea ease flecting the host and pathogen changes: The pidemioiogy of nfective endear has become angled with healhese sociated factors predipeing locking loo ow nto the main poring chamber of Your hear (tek). Mia vale steno cn make the person ted and shor’ of breath. The pathophysiology comprises thre crea elements: ‘alr src, end survival ef the adhevent bacteria on the surface with the propagtion of he infected ‘gettin 2) Under nl eneions, Rng infection area. The inane sytem protect aginst ‘ales. Teltrasound of the hero od eultirer te he supported ets and suspected yng Patients with pacemaker es, fil heart valves and abr est valve are more ete. The Arveloping infective endoari can predipone to stactaral heart deat [5A ie threteringiness ‘eas with motility and mortality: Tuo abioti medical ar har weakened the death ate ave endocareti Infectv endocarditis vegetations gow onthe valves and produce toxins and enzymes tht il and beak down the tissue to aus ols nthe valve. The resting complications are Enboism of ater rom the ‘seettion can get inthe way of blood fw. Valve replacement therapy andinra-ardie instruments are Increased in hsptalzaton,Disbetes organ transplants, end-stage reval isease and human Inmmunodetcencysyame ae nce, whichare he dominant factors of rn eases. The most ommeniy affected ron the endocrdil ning, which ene deadly dates were, The eleant ‘iktactorin any une naval can hae erent hago aspects), ‘cara seer diseases re mainly due to bacterial nection. Rheumatic ever nd endocads aretwo kane 5, Aan A (Setenbe 15,2022) Paton, ips, Anibal Terny,ensMengeret of ete Enscals, a ‘Conpestos uu oy eva bal Y.reatonmn 982Cureus ‘cxample. Crain blood-borne stra cme in conte with he ends ning and cause ceria ndocriti The anatomic defect nd sbnaral valve are min considered Tete te wo peso infective endocarctis: abate ar coe The viulence of he organi decides wheter the nfection isaeate or mace The arganim with mor vrlene calle sbi, an low vrlence called a sate infcton. Te sgnfian fete iferene betwen tact ap ee ison in table Resistance tothe crc new aioe alta emerging woe opts he "amen of anit topes new aioe and ao he prescrpon of molecules known to favor the spread of sistance, Cnet tenees| ‘Sebnonapa cig ges, pth Dose stone stan Provo contin Proust daranes uly eat nara ost conn erga “Srpocosu ans Sets sue TABLE 1: Feature differences between subacute infective endocarditis and acute infective endocarditis Review Pathogenesis Pathogenic acter find way to ente and exit the Mooéstream ané the surrounding tissues trough the ‘endothelium, tian inetace betwen excusing bled or lag inte ume and the et ofthe vessel vel 01) Platelets, rin postion, nd surface disoption may lead to valve aus an produce date cel alteration. The src i suscep toclonization bythe crusting acter, which render an do ot ease any harm, Fin platelet matics ore commen than ater; some Bete ‘rains apps toahere most quel to the sce ining The comple, which attaches othe inig i ‘nos commanypolsechrie(exiran, which acta thevrlene factor ofthe bctrn.The race ‘egttion comply, andthe adherent bacteria sive onthe endothelial sre, The ting cates Inte by vegetative propagation. Batra an ung infections usualy do not affect te standard ‘dota ning ofthe bear and its valves. Vegetation onthe endocardium anda sequence of intetlated eonsoquences occurbeore microbes ate teste. The infecting organs of the vegetative fermation depends onpathorenes ‘Vegetation formation sa mulkstep proces. The fret sep is endocrdlinury, The mos ommon ‘mechani is ijury by eubulent lod movement rom congenital intracardiac abnormal, The !mleroorganisms eeu the blood stele patlet and vin formation. The dermal and he mucosal are Infections of alent bacteremia, The exis clotting pathway ofthe congulaion stm satiated fury, wich cases the lease of various etokines fom he adherent monocyes. Pures deposition of ‘Abronetn continues athe endothe eis tar. Vegetation the culmination ofa mlcsexpe ‘vent 115 The ongoag infection becomes more dif to erat acters owe nade the ‘Abroncctin matic ncn, making the hosts anune stem nt respend appropiate. Sapfyocacaus aweas(.areus i aspeis wi high Wrlene and can net the standard catclac valves fauna ting Subsequent ineralitation Info the endothelial els andthe extaceiuer mati binding poten ae ‘mechanisms tat bind the S. ares bacteria |1s)-Tey further induces destruction by leasing ‘ropoel, which endthalial els actvate when the cera invade th hosts immune system "Nyocatdal abscesses, tue dstctlon conduction system abnormal, and stden sets cause heat fale of death of the human, These ae the exe consequences flea ineton The vovement fae ing abscesiesis due to wide presto eases of prostatic va infctos, partie aos. The sabe bstueton manifested by mycotic aneurysms, myoerdal abscesses, obstructing vegetation enducion disturbanes, and dehiscence. yremie coke ilaes is emboliing inetd substances om. the eat valve immune-meieted phenomena, Septic plmoary embolus sights sion hat uses empyema preumonia, nd pulmonary diseases The let-handed lesion emboles he ental. ‘nervous system, spleen, kidney, and oter sues 15) Difluse garulonevts equa ocars in ‘ena embol cutaneous, nd depen. The endothelial alls pode any raion i any trauma acura ‘aa en al Cran “AG 29102, DOT TOTS 292 Bal?Cureus “Tae ical damages are possible in infective endocndiipathogeresis Icing ace poiethemia cyano, endothe dame, naineated blood viaronty ar leasing to compistions. The ‘ost otiesbe increase sin aria ipl uch 2 prosthetic ales and shunts tis ot astonishing {hat yanaie CHD witha uve santo prosthetic valenepetet the highest ik frineced ‘ndocriti Neonatal endocarts ftenaccartom th est rights ni ssoited wth option ofthe endocardium or valvular endothelial tise produced by cathee-nced rama) Te dermal ad ‘cout membranes experince rent ama detbsteriainprematre neonate rhe paceent of ‘amblso eriphral weno catheters, parenteral hyperaimentation, an igo endtachsl ‘toning, Te aterm combination nthe endl damage ae the etal nection of nective doer Infective endocarditis diagnosis and role of blood culture ‘aru diagno et are pete for infective endocarditis. With the help of symp, treatng the tint well and agnosie dna iene, Medi tents and spor ae sportanfctor, Tels that help te dteetendocars are lod ature tests, which epi etecting the erin the lod. The Cormbination ofthe abs and eaten! usualy depends os the lord et repo. The comple blood un appetanceineetses inthe while lao cel A blood clr et esl help t find nection in the oodstream Sepiemias an infection that occurs when ace enter the loosen. ca ead to sees the body’ reaction tothe disease, whch can enue rgtn dese and even death, sgn of doer 18 urtherbiadtess ther than thew are cari out to check teeta ofthe infeton. Ina chore, the sound waves reat mage fhe her's beating, tthe tet that shows the eae ‘hambers athe blood purng trough the eat’ valves. The struct of he her sates nh et “Twotyper of echocardiograms ate use inthe medical el. Ina ranatorai andar) echocardiogram, = veondalte device fr maved oer the ches aes. A ranssophapalechocrdogram aides 3 toe that, Connects the ost othe stomach lt provides mare detalisaboat the hea satire The eect asity ‘measred by ths method is usually ples and quick. The leas of CG are general tached to the amas {nd egsalso. can show the elec activity ofthe hea ifanthinghappes ts nt used expt fo ‘he detection of enocadts.Aneter ests the chest ray, which eis ose te internal onan, Hk he heat and the lng. any infeton has spread inthe gs any swelingin the at, can be sce in the era. The to other testa perfrmed are MRCandCT scan. Thee teste ate mostly done to can thera, ‘chest or oher ody parts if the ineton has pes ‘The infctngmicweorgansms in the loo are rected inthe ata disease of endovascular endocaats Determining the disease condition and blood cultures the primary ts fr te microbiologic etiologic Routine hematological cultures proceate on automated observation fr anos allendocaris cultivable ‘agents. This process helps to avoid accumulative extended incubation rast subculture. Guidelines are set forthe ining the numberof blood clare a teomamended, cording ote Baropean Society of ‘arilog and the american Heat Association, the diferent venepuncture sites ar the thee set of blood cultures. There shouldbe 2 one-hour gap between the fist andthe is In he subacute chronic edocs tre blod samples and acuespssare collected in one hou to sixhous. The Bris Society for Antimicrobial Chemotherapy (BSAC) recommend antimicrobial chemotherapy ‘One anaerobic nd one aerobic ot contains tne sets f blond cultures. They are athere in two oun oftotes, wo onative and one ansezbic tes er se (bts i total) The adequately led bette td theyeld of the culture ze detly proportional tthe volume of he led cule Mast ood clare fof along-sutlering patient with endocarditis oeate fom ogunsmseuvatd in the cute systems "ood mutt be fimatv, The beet of clleced bled ulus sippy that lod tastes are suably herd and drawn preceding che management of atimlcobal medal ald nd individual. The fexrespendence oan endocarditis pathogen sould yl shaw the postive culture ofthe bod sample “Though the theory of atbuted acrangeten of neverending changes in bacteria was published inthe refered dection, modieation af eultute of bod draws over instance sot the ast fr routine ood culture (9) Weare unsare of evidence supporting the valu of spaced blod culture daw freologi lage of endocardts Reatiney spacing baod clare eaminaion snot recommended nesses ef suspected endocarditis Standard bled eure wth Sve days fieubtin ie s adequate or healing ‘dns al cultivable cautes of ndocardsinoding Candi species. “The ngunams Ape, aemophi, Cardisacterum, Enel, and Kinsella ae challenging to ‘lecver inthe ond eultues du to hee date nature. are the extended iebtion periods were onsidered with exiting blod alte syste, prolonged neubtion (and end blind suber) redundant for terecoery ofthe gas, the are wel row and noticed within the ela five-yieabaion period. Te acta blood entre method als conan aulficentslendeer to support the grow of thotrphi and granaleatella spies. rae speces ecsionally cate endacars a ate observed it foutine blond eats, Te non-serolgie examination maybe alitalivel he exposes Inia Bre ener Catbacterum (opianibaceriam acres (aces) dese etd Infoation However, he speces may requiem extred cod ett nebation pou coding 0 ‘he Clinical ad TatortryStandadsIaitste plies, the end subelare ofhe cocoate medi i ‘aa en al Cran “AG 29102, DOT TOTS 292 saCureus recommended ifthe ther band cltres show negtive pot of endocaiis|2), The wena fhe bin sober sully as the shred of evidence; The BSAC guidelines donot approve the practice ‘Te species grown in lao tre are cand pais tat ae Fung edocs soplasma copsulstu ana asperisspeces re rarenon-candde Fra wich cause exdocartis Speired fuga blood cultures and antigen tection re the etng methods er edocs: Many people with endocarit's are uccessflly ereatd wit antibiotics, Sometimes, surgery sugested to fx damaged hear valves and clean up the infection. The cultures must be cleteé ‘ppropratey. The most frequent ocutng ecg ute as negative endear is Covi bare: burnt Barone speces arin, gram-negative bail that aus endocarditis. Barrell ‘untana the agent of enc eer, and Batoel hese the agent of x-srath ses are the stgiican causes of aronelsendocards, Due othe prolonged incubation period of stains andthe bacterial species ofthe loo culture, . anes ian requent use ofenocaris. The molecular agnotcmethod of gate cult eodocadise 9 wigse factor considering mycopiann revo ‘an anctody serologic testing shows the iewune system that an Ta offen esases. Du to ‘onspeic nial andradiogrepic presentation, communiy-acaured pacuonia (CAP) Includes Leola, Clamps, or Mpls cagestc challenges. Numerous microbiologic tools hive ben develope to determine intensive infetion ‘The traditional bacterial euture doesnot shaw any seroegeal repos postivey eg. buen ori particular Borne spaces), Digno can aid the solo erlution Brucella endocads s used nection of acl Species. However, uecordng to mediied Dukes tel, these pbgens ausesub-acute endocarditis, whlch sults inthe elvtion of ig titers 21. The best accepted secogie tHfor to ent endoars s the eciogy of buna. Acorlag to mile Duke’ iter. Howere, ‘toe often dlagosed Bartonella endoceh ithe meted of seologl tein. Te etlogleal agnosis of the infective endocarditis ges complested by applying srlogeal ner erost-resetvy.Clamydophle ‘rts bors) a rt>negative nacelles, the species reeponible for enaoote ‘orton aborts was prevoly dentited as Clamp pita. soc nections with C ‘horas and C bare ae repentely rept, sulting ina abe postive The stlagl esting causes rate docrdts which s why Osean manifestation not ecommended. The inmunalogi vse, peripheral enol and active vei are evidence of baeterera or ingemi. The HACEK group of acters aemophis pecs, Agregar specs, Crdabacterum hms, ena corrode, abt ‘Aig species ate asl heterogeneous goupf fasts mieoceganisns that are an unusual case flee endocads. The lftslde value involvement doe not reste vascular phenomena nd periperal extol “The variaons in the clink epesntation quai ee the mos cea planning. Patents inthe VDA up Gtravenous drug abut group) Sees wih igh-sied infective coders were ejected ‘elite cates The purameters vaca complications new egurgale ur and persistent bacteremia te the dace propeten, Mote or les the fining of echocadographic el ine ha VDA is ‘cepted ata progrenvely portant inherent cemotiassumption fo development. The high oralty fate rant common in ightsded infective endoarts Opposite the coronary ius the ep aes ‘eet affected. The coronary sinus vegsation, the outcome, the eatments ad the diagnosis re ot yt “The abnarmal laboratory test andthe multe of signs and symptoms canbe the cause of endocarditis A asin agnosis iil beeae many are nonspecfie 2, Te syromie agnosis ae clad ndocrit reais varius observation and ining forthe approval ofthe aeae a t= "yptomatic The daeate dagosi sare on combination of abroad ctrl Sings. The tint can undergo surgery or atopy iF only accepted bythe Beth sal teria. In practi, teal by ‘andomiation of resent sem ely a enable a rearonble decison Te proceso analyng 3 ate shoal pv itferent weighs to diferent finding. Te Joes, used acotereumai fever, athe better-nown example ofthe weighting éagostic popes It stems stable tose a paral preach toward diene to dingrose infective roca. The Duke's crtera highly define minor and sgieant symptoms to apply o srgry if eessary. The subgroup of patents s made of the nes who ae rugs ‘eth sided endear tents with wave infetons. nfs wth congenial hen dest and emplicated prosthetic valve infections ar also 2 subgroup ofthe Dukes criteria 25, ‘The diagnostic challenge for physicians scltre-negatie endear Teadtonl methods such 35 soogy, Serle, and cure new molecular techniques have been formulated to improve the detection of emplox culture agents. The soli tests locked fr atibodes in the Wood Seong tes for eo proteins the seas caused ecologic agents, Cola but ané Barone These of nove iss cel lines can reduce the sestivty of tecture of bacteria which has ben done by improved injection of he samples in the shell vil Ifthe patient ase ostve blood clare ang cardiac ala Ison the agnosis is srghforvard onthe fist consideration. Probable panic stato is eeated when even 2 singe suspected eases reported. A wide ange of spies can cause his the dct vsualzaton ofthe unary sion in he valu vegetation and differen symptoms tat may be sean asthe disease. They can mimic any othe ness wich may have asia linc pesentaion. Tough the cetalny fcc practice, tismoe challenging to make a ea-utdagnoss of endocrs The ovedagnass or ‘aa en al Cran “AG 29102, DOT TOTS 292 4aCureus undergo of endocarditis in nboratory ndings i routed aod miiagnose. History physic "raminstin an choardagraphy are rome ofthe arf anshzing properties kee in mind. The dentifcton of endocrctisis made into phases: nial ssesspent aed therapy andin the second hase, definitive diagnosis and estat 24 “The Bent process isa cardia surgery aseciated withthe graf replacingof the artical, antic root, and ascending aor, After Bealls roes,rattnfecion severe and much morechllengng9 diagose and eat PET/CTs an aerate method for digoss I hypodense accumulation observes inthe Dior gra, which cons the diagnos, the surgery emains the sable treatment option. However, itray not always este sven the complexity and high-risk nature ef the procedure, Medial therapy vith longed antbaisi eecive for nonsuriealcandites, PETIT corlates poorly wth the lina esponse;hence, tis nt sugested 2 olow-up 25) Antimicrobial therapy “The min foes of tinerohial eherapy ito avid toi to the hos andthe emergence of estance Ria not st ite tthe ram-posie organism ba the rb per [2]. The sai eveats ate he factor erentedby the extended use of antibiotic therapy. The properties of sniicabal herapy are pharnscodimanies, pharmacokinetic, and antinirobil agents Clinicas maize the aiimirbi _srup sreptco species insted that outpatient parenteral sbi tetra much afer. The Infotion auring endocrine. The dare caused bythe aureur species primary Wher for ‘management ffi [2 ‘The sfety and efieay ofthe seamen with fap ative valve arent addres in past tos The dsc for nfection of epstotoic, dag interartons, and the outgrowth of immune Sars ae standard Riampin sa medication wed to marage and et various mycobacteria and gram-positive bacterial infections, The efective management ofthe ative vale S. ares nection reuies an sppoprate corse of antimicrobial agents. One of every sx infectve endocarditis patients doesnt sure, ‘Approximately 80 percent of ytint can survive the intl hospitalization tothe nection wt igh ‘utent organisms, one-third f patients may de asthe indirect or dec result of vaar isese, Modern Aiagnostcechiques urge ufeorable outcomes inpatients reevng appropriate antimicrobial here. “The issues frequent ad inappropriate use of ante, lack of educational ewarenes this regarding antibiotic usage, ane the ako infection contol nd sanitation make te stuation worse, Te cutpatent paentcl ania theczpy (OPA) nthe home environment and deemed suicienty stable are Eermparebe properties wit the patents under tetment in the hospital, Inavenaus anos ‘dmunstation and hositallastion are the high costin resting infective endear. The vit succes of ‘OPaTuintctive endocarditis the cart selection of the patents. The patients willbe hemodynamicey stable without any cinta complications. Tora aot prosthetic raf infection srlatvl ae; tints undergoing horace erie surgery have become elder and enture more como. Experimental moels ar urgently neededto modiy states fr short and longterm prevention of ‘hora aot atinfection (25-28), ‘The goals of OPAT art alow patients to complete estmen safely ang elective. The home-based system included an infectious diseases physic, a mlrobilogi, a cadologist da nurse splined in Inuavencus procedures. Outpatient treatment of infective endocarditis ssl uncommon, Ate same ine, home inuavenous ania therpysncresing forthe various ineevous leases ag mctoial, agents. nfctiveendocaris present ina patent has a divest of pathogens. Thelagh suscepti pencllin advisable for eating etrepocat Infections, ete American Heart Asotin AHA) reported “The nate valve iaveied Esper spate enteabae Spces, Enercocs Spe, ‘Saphyoscut specie, and Srptooca poles, These ace ome of the causative organs, ‘Management and complications ‘he exracadiac andthe adjacent hear sructres are the few affected complications finecive endocartis, The person withthe infection haa higher sk ofhaving congestive hea are, the most vere complication, which est death 2), Patents with hen fore requ tensive medical ae, {nd cardiac valve exchange sould consider antimicrobial therapy iespecive ofthe duration All he sujet with acter infectiv endocarditis are hemodynamically table with no multiple lage emboli “These may acquire atleast one course of ntimirbil therapy to serie the sete vale carb han the cardiac valve satiation eeone ‘he technologie boundary of 2 echocadography of infective ndocaris with ave vestations incontestable It doesnot give adequate nforution to uphold the cedac valve substitution ently on cheeardiogaphic cleo. The her flue meray ates higher tan tat in cardia valve replacement surgery due oendocrdisinfction, Aor egugtation an myocardial bes are stgnieanproblens Mos ofthe patents may present with vaya ompieations 2,50. Management offered prosthetic aor graft the ascend and oot complex and muiacetd ‘aa en al Cran “AG 29102, DOT TOTS 292 eaCureus “Tre nteof uel competion depends upon the variant of he infecting pathogen the period of zeae before therapy, andthe type of eaten. Nevers, earring the aca een of ‘omplicatons x moh more challenging cee the dies founded on een erp hate ‘snd sarioas diagno enter The cd and extrac ae the two rnin caterer of nective ‘edocs Staphyenens epidermidis causes prosthetic vale endocarditis. Gram-negative ceria are resin tthe mos avails abiotic. The valve-eata problems or the ators uch athe postion, ‘pean ize ate further analyed in the proshtievale endecadt the changed valve shel be ‘rained wel per the erospectve sty (5). Conclusions Infectiv roca the fourth landing ese of ie-theatening lvetous disease syne The sdvancerent in atimieroblal therapy and the development of beter dignostic and surge techniques have decrease mort and mortal Using newfound cine eter and npn echocardiography wl gid the rato: incorrectly diagnosing the disease, The verse wal ave ‘alla muscles Ut aupor the sroventicular valves ough the corde lendinee ia eaepeized Ino inetve and non-iletve endocarits ased on the presence o vegetation In non infetve docs tiny apd serie vegtalions aggregate se long the ees ofthe valves o eu This Form ‘endocarditis is alo called arate endoarits,ninfcive enor, the body result is infemmation whieh cour when the condition i ransent.actereni ithe spe peseceof bate, vile spice the presence and mtipleton af teria nee blood: Perr pac i ype of ‘pseudo widespread aacete of metatatic nate. Since the vegetations in endoaris are ‘yp ible these are toe ncladed and dislodge inthe rp stream ofhe land, which ves isto ‘re tubercalos phi fangal, and viral endocarditis, Te lesions an igh-ided infection, ef-sided ‘antimicrobial heap. Management ofthis comes along with adopting seal ifexse and staying Additional Information Disclosures ‘conflicts of interest: In compiance withthe ICME uniform disclosure formyl authors declare the folowing: Paymentsersies inf: Astor have delted tt ne finanea support wa eee rom ny organization fr the sobited werk Financial relationships authors have dearest hey hve ‘inane elaonstips at present within the previous thre ers with any organizations that might have an nest n the submited wor, Other relationships: authors have dear that there aren ee eationships or atvties hat could appear o Rsv nuenced he sbmited work, References 1. Mylnie, Clr Sinfonia. ng Md 203, 545150, 1o,0sentNoi0082 2 gee dear 202, Acad: gut 6202 prow cee lnroesonalrconrlsearseneneridteefocncencrcste fates un ecive endorse Cadalog Mad Mai HA ed Ese BY, Tete 218 aa, olweatteoatise 4. Gade Won WR Bayer AS, cea: nee ndocari dagosantinicabil herp nd menagenes of eomplictns a tae fa ele ptessonas om te Cote en Res eve Ea dcadis nd Reet Dace, Cate on Cady Dies nthe Yung the ‘Aslan: rd the nections Disses Sct of Amerie, uation. 205, 13454 5. Bayer AS, Gage A, Take KA cal: Digs and management fic endocadisandite ompictons Ceiin 194, 96250681 ie cr a5 56 1 Bent, Aton lun ME Vaetted aces na inert prostate va endocts arch Trtohir Pe 220, 117620. 9200010254 1 dear Practice ara (2), Ace Aug 15,202 rpsemedne meee com aricies50. cre Cara el oA, Gr ea Hay and sft ooze’ parenteral abiitheray et Inetive ener en-year prose Elem ce abl Ci 201, 295872 TosolwteimeaniLosoor 9. abit tren fe Ft: Abit props for ectveendcaa tena eve sedan Hea 2017, SSS Sees 201509102 10. fea Var an inet Eno (02, ceva Ags 8,202: pit econ heait-olearaepebensant-dsesteer-ae-pblesan= THU} L600] HR DHE x Mlcbi ine 984, 438108160 111) 165-091 oeeenHaa 15 lotT,Foerler) Goud FX ery 0, Senoe 4 Glee arte abit eament of ‘aa en al Cran “AG 29102, DOT TOTS 292 eardecd inautrept a he Wecing Paty of he Beith Soke fr Annbil hemotetpy: atmo Chemoter 2006 549718) 10st Ende (198K), Arend: Ag 15,202: pemwameonine ar aatee. onaionsedectdisdagese-eeinesU- 2055258. ord Dag Tre 215 1478, 0.174 18 Tste0 9 Nr DT, DelnaeF, Obi a; Ao ve placement ate ect endocects: 588¢ vial comparison of epost, Roneal ech poste Ear] Cate Su ovo sTaaz-32 0.4081 ous Raul igus etd caren best practices nd ulti for Wenn of uteut-t-cutre rations in ince enc Cadt Cl, 08, 21207-1710 0183075 fsasoouzsc hh 6, Horn 8, Tarot ec Calls onthe poet, dsr, nd eton oft doce tn ein 200th Ts Force on te Peetin Dagon Teese of nee Endo of heEisopean Soe aap SC) Ended by the European Sey of Cita leben inet eer FSCMID andthe Iteration Sy of Cees (SC Infecion an Cancer Eu Hea 210, 31236498, 1010p 88 “Thee Heat Survey Vb Hest Deane Ea Hew 2008, 2612 065055 sesxosamax 1s, saxon Dy Mkt a= Proposed medio the Duke ester he agnosis fineive eeced. Cin Infect Da, 2000-8 L0.080515)55 occheganl Nets Completions finficiv endear. Crees Hamatl Db Dre Lr A Rees MPtra-Dlon Sta: Outpatient ester ninco hap rife ecb acon-ferve rtgy Med Mal nf 2014 48527-3010 09> sc 014080 Sallam PM, Drake TA, ance MA: Phen of beds Ar Med 1985, TBIIOS. 10 1015000 sasaopusrs Rare iene Data: infcive Broads. 020, Aceed get 8, 202 hrpsaredseaesonprare-aiseasevencocrdisnete Bata 4 Pada, igh Shama YP: Ree of PET/CT sean neni at-nst rt inein| sowing Bentl procedure BM Cae Rep 201, MSE ness Song, ang hang a Rigs nee oars with coat Ss vegetation MC etapa, aor Boer Sen, MM Fovier Ce ec endorse, Nt Rey Primers ate, dae verse of sarge of fete Edecarsin Ads 02, Ase Aus 1202: n/n nineteenth 146958710100 ache 03a aS Tepnwan 7, insite, Trower A Tessa N Wraidsonglchasstenshong cede. en Tha Carat Sig 291, 6110807, 10 06911 Aho. ae (Cue cine F, Cui C Cara |: Curent cles in the mangement finecve secede ron ed uno 221, LMS 05011208 ‘aa en al Cran “AG 29102, DOT TOTS 292