若出现发热性疾病,应怀疑心内膜炎,并在抗生素治疗前获取血液培养物。应根据可疑程度行经胸或经食管超声心动图检查。[35]Mylonakis E, Calderwood SB. Medical progress: infective endocarditis in adults. N Engl J Med. 2001;345:1318-1330.http://www.ncbi.nlm.nih.gov/pubmed/11794152?tool=bestpractice.com目前只有心内膜炎特别高危的患者才需预防性治疗:艾森门格综合征患者;有感染性心内膜炎既往史的患者;采用补片修复或经皮器械封堵术闭合室间隔缺损后 6 个月以内的患者;或闭合后有残余缺损的患者。对于常规胃肠道手术,不再建议使用预防疗法。[1]Warnes CA, Williams RG, Bashore TM, et al. ACC/AHA 2008 guidelines for the management of adults with congenital heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Develop Guidelines on the Management of Adults With Congenital Heart Disease). J Am Coll Cardiol. 2008 Dec 2;52(23):e143-263.http://www.onlinejacc.org/content/52/23/e143http://www.ncbi.nlm.nih.gov/pubmed/19038677?tool=bestpractice.com