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Table 52.9

Monitoring in Infective Endocarditis

Clinical assessment daily, more frequently if there is a change

Record blood results on a flow chart if electronic systems not in use

Check creatinine and electrolytes, initially daily, then twice weekly as condition improves

Check C-reactive protein and white cell count twice weekly

Check vancomycin/gentamicin levels as directed by microbiology department

With aortic valve endocarditis, record an ECG daily while fever persists (prolongation of PR interval is a sign of abscess formation: arrange transoesophageal echocardiography)

Repeat transthoracic echocardiography if there is a change in clinical status and before discharge (to provide baseline against which to compare grade of regurgitation and size of left ventricle on outpatient studies)