We are the combination of four hospitals: the General Hospital, the Children’s Hospital, the Women’s Hospital and the Traumatology, Rehabilitation and Burns Hospital. We are part of the Vall d’Hebron Barcelona Hospital Campus: a world-leading health park where healthcare plays a crucial role.
Below we will list the departments and units that form part of Vall d’Hebron Hospital and the main diseases that we treat. We will also make recommendations based on advice backed up by scientific evidence that has been shown to be effective in guaranteeing well-being and quality of life.
Vols saber com serà la teva estada a l’Hospital Universitari Vall d’Hebron? Aquí trobaràs tota la informació.
Infectious endocarditis involves the presence of a microbial infection in the endocardial surface (internal surface of the heart). It is the most frequent cardiovascular infection and it is very important because of its potential severity and its different forms of presentation.
Infectious endocarditis mainly affects cardiac valves, whether natural or artificial, although sometimes it can occur in other structures of the heart.
It is classified according to the time the infection has been established (days, weeks or months) and according to the bacteria or microorganism (yeast, fungus) that causes it.
The characteristic lesion of infectious endocarditis is endocardial vegetation. It is made up of the completely abnormal presence of an aggregate of platelets, fibrin, bacteria and inflammatory cells that adhere to the internal surface of the heart, usually on the surface of a cardiac valve, and which is susceptible to breaking off, causing an infectious embolism at a distance in another organ (skin, nervous system, limb).
It is considered a serious illness and although in most cases it is cured, it also has significant complications and mortality despite treatment. In many cases, patients must be subjected to surgical intervention in order for it to be definitively cured, eliminating the affected tissue and inserting a new artificial heart valve.
In its most acute form infectious endocarditis can produce high fever, chills, prostration and severally affect the patient's general condition in a short time period (hours-days). In subacute forms it may evolve over weeks or months, with a clinical presentation of tiredness, lack of appetite and low-grade fever. In these cases, infectious skin manifestations may also occur as nodules or characteristic spots, which do not always appear.
In patients with severe cardiac valve involvement, the valves themselves may not function correctly, which may result in symptoms of heart failure such as severe shortness of breath and swelling of the lower limbs
Infectious endocarditis has a global incidence of 2-3 cases per 100,000 population per year, and so it is estimated that in Catalonia around 200 cases are diagnosed every year. Its incidence increases greatly with age, reaching 15-30 cases/per 100,000 population/year in over 65s, or 10 times higher than that of the younger population.
The cause of infectious endocarditis has changed a lot in recent decades. In recent years the most frequent causal bacterium has been streptococcus, especially a species called viridans. There is currently a great variety of causal agents, although staphylococci are the most frequent, followed by streptococci and enterococci. It is, however, advisable to note that any microorganism that circulates through the blood can adhere to a heart valve, especially if it has previous injuries or is an artificial valve.
The diagnosis of endocarditis is based essentially on:
- blood cultures to identify the bacterium that causes the infection and allow the most suitable specific antibiotic treatment to be chosen.
- echocardiogram that allows the endocardial vegetations typical of the disease to be located. It also informs doctors about the function of the valve affected and contributes significantly to assessing the need for surgical treatment in some patients.
- in some cases it is necessary to carry out other explorations (such as CAT or scintigraphy) to rule out the existence of peripheral embolisms, which are very common at the time of diagnosis or during the course of treatment of the disease.
The treatment of infectious endocarditis is antibiotic, but specifically targeting the microorganism that causes it. The doses are high and prolonged over time because the vegetations typical of the disease are not very vascularised and antibiotics must penetrate through diffusion from circulating blood. In patients who do not respond adequately to this antibiotic treatment or who have major valve damage as a consequence of the infection, it is necessary to assess the need for valve replacement surgery.
Blood cultures and echocardiogram, both at the time of diagnosis and to monitor the evolution of the illness.
When an alteration of a person's heart valve is recognised, antibiotic prevention must be administered before any dental or gum treatment is given, following specialised consultation.
Preventive measures must also be taken in the case of endoscopes, especially of the upper gastrointestinal tract (gastroscopy), with the antibiotic and guidelines indicated by the doctor.
This prevention is very important because the presence of bacteria in the blood, as a result of the intervention or exploration, carries a significant risk of infectious endocarditis.
The Drassanes Vall d'Hebron Centre for International Health and Infectious Diseases is a clinic specialising in communicable diseases.
How to get there
There is a team of medical experts specialising in infectious diseases who work from the centre of Barcelona. This care facility provides specialised care for patients affected by certain transmissible diseases, diseases related to international travel and those at risk of suffering from them.
The facility is open to people of all ages, including the paediatric population.
The medical professionals at the Drassanes - Vall d’Hebron Centre for International Health and Infectious Diseases specialise in the detection and treatment of infectious diseases, from sexually transmitted diseases to illnesses brought in from abroad. Early detection and a rapid response are the hallmarks of the Drassanes - Vall d’Hebron Centre for International Health and Infectious Diseases.
The centre has medical personnel in the clinical environment and the diagnostic microbiology laboratory, a nursing team and administrative staff. Patient care is divided into five distinct areas: sexually transmitted diseases; international health and travel medicine; diagnosis, treatment and prevention of tuberculosis; paediatric care for any of the diseases above; and a diagnostic microbiology laboratory.
For any questions or queries, please call +34 934 894 408 or email: ccee.drassanes@vhebron.net.
This area of the centre provides immediate help for patients with symptoms of sexually transmitted infections.
This programme called Drassanes Exprés provides early diagnosis and a rapid response for sexually active people with no symptoms.
The professionals in this area provide specialised care to any patient showing symptoms compatible with diseases acquired in other countries, whether after a recent trip abroad or for immigrants from other places with a risk of tropical or endemic diseases.
A dedicated and ongoing international travel advice programme is part of this area, which includes routine vaccinations and specific antimicrobial prophylaxis depending on the destination and time spent in the area. You can book an appointment online, by phone or in-person.
Lastly, a team of professionals leads the Community Health Programme, which fosters healthcare integration for new arrivals from zones with a risk of tropical, endemic or communicable diseases, and to encourage some users to become “expert patients”.
The Drassanes - Vall d'Hebron Centre for International Health and Infectious Diseases, which is located in the Raval district of Barcelona, also specialises in the prevention of tuberculosis. Risk factors such as smoking, alcoholism and drug addiction have caused a rise in the number of cases, although it continues to be a rare disease.
The Vall d’Hebron-Drassanes Tuberculosis Unit leads the field in both in-house and collaborative research, and each year diagnoses over 160 cases, mostly in the city of Barcelona.
Professionals in this area provide care for patients with a suspected or confirmed diagnosis of tuberculosis, particularly when the lungs are affected. Given the location of the centre, most patients are migrants or have a high level of social vulnerability. The care these patients receive is fully coordinated with the Barcelona Public Health Agency (ASPB) and includes monitoring throughout treatment of the disease until it is resolved.
This section also attends to a large number of people in contact with those with active tuberculosis in order to rule out infection and to provide appropriate treatment in each case. It also deals with groups of people at high risk of having an active or latent form of the disease according to ASPB recommendations and requirements.
The centre has a group of paediatricians who care for the entire paediatric population requiring treatment in any of the centre's specialist areas. In other words, international health and travel medicine; diagnosis, prevention and treatment of tuberculosis; and, more recently, sexually transmitted diseases. Caring for these patients often requires coordination with other healthcare professionals looking after the parents in the same centre.
The laboratory has all the necessary technology to rapidly diagnose certain communicable diseases through molecular biology, and it also uses conventional techniques to diagnose and monitor some of these diseases.
The Microbiology Laboratory has played an essential role in the launch, maintenance and growth of the Drassanes Exprés programme.
Meningococcal disease (meningitis) is a serious infectious illness caused by a bacterium called “meningococcus”, which is transmitted through pharyngeal and nasal secretions.
The risk of contracting meningitis increases if you come into close contact with someone who has it (if you sleep in the same room, live in the same house, kiss on the cheek, etc.), but there is no need to disinfect objects or areas because meningococcus bacteria do not live long outside of the human body.
The measures to prevent this illness are:
With meningitis, the appropriate measure is to administer antibiotics to the family and other people who live with the affected person.
If the illness was caused by meningococcal group B, the only preventive measure, and the most common in Spain, is chemoprophylaxis, which aims to eliminate the microorganism from the pharynx. This stops it from spreading, in the space of a few days, between the people who have taken the medication.
If the illness was caused by meningococcal group C, as well as administering chemoprophylaxis, people close to the affected person will be vaccinated if they have not already been so.
If there is evidence that someone has had intimate contact with the patient in the ten days prior to the occurrence of the disease and they have not been administered chemoprophylaxis, healthcare staff must be informed.
The only way of effectively curing tuberculosis and preventing others from catching it is through treatment based on combining different antibiotics for a minimum of six months. The symptoms of tuberculosis often disappear quickly, but the disease may come back if medication is not taken correctly and for the time indicated.
Currently, tuberculosis (TB) drugs are safe and effective, and the majority of people take them without any problems. In some cases side effects may appear, so it is important to follow the treatment plan under supervision and see a doctor in case of doubt.
Once treatment begins, and to make sure it has the desired result, follow the instructions below:
Urine, faeces, sweat and tears may be red/orange in colour. This change is normal and will disappear when the treatment comes to an end.
CDC - Preguntes i respostes sobre la tuberculosis
Educating patients with resistant osteoarticular infections is key to avoiding contamination of utensils and possible complications resulting from the infection. Healthcare professionals will therefore emphasise the importance of hygiene in the infected area and will give instructions on dressing the area (if required) and on taking medication correctly for the duration prescribed.
When the patient is discharged, nursing staff will give them all the support and information they need to be able to look after the wound themselves. Most patients will be fitted with an external fixator that needs daily care, so healthcare staff will emphasise the importance of hygiene in the affected area, which should be cleaned daily and the correct dressing applied.
If patients are not independent and do not have a relative or carer to look after them, the local health authority will be contacted (through the PREALT discharge preparation unit), so that they may be provided with nursing care. If patients are being treated with intravenous medication, the Hospital at Home Unit will be contacted to follow up and provide the relevant treatment.
It is also necessary to explain the importance of taking the medication prescribed. On being discharged, most patients will receive long-term oral antibiotics (prescribed by the Infectious Diseases Unit) and they are reminded of the importance of maintaining a fixed schedule and not forgetting to take their medication.
They are also reminded of the need to maintain healthy habits, such as:
Currently, Zika virus mainly affects some countries in Latin America. In order to avoid the risk of being infected, therefore, we advise travellers not to visit those countries during pregnancy. As there is still no vaccine to prevent the virus, prevention measures are fundamental to avoiding infection.
The advice to prevent infection with Zika virus is particularly aimed at pregnant women or those thinking of becoming pregnant in the short to medium term. The possibility of transmitting the infection to the foetus means that pregnant women are the most vulnerable group. For this reason, you are advised to:
Another way of preventing mosquito bites is to avoid proliferation of mosquitoes, which you can do by finding out and periodically checking the areas where these insects reproduce. Once breeding points are located, the measures should focus, as appropriate, on:
Respiratory syncytial virus (RSV) is responsible for 75% of bronchiolitis cases diagnosed during the epidemic period, from October to April. The main symptoms are respiratory difficulty and the existence of audible wheezing. Although it is a highly contagious virus, there are a series of highly effective preventive measures.
Acute bronchiolitis is a respiratory tract infection common in infants under two. This infection, caused by RSV, manifests itself in mild or moderate catarrhal symptoms, although if it is not treated, it may progress and cause serious bronchiolitis or pneumonia.
The symptoms of acute bronchiolitis may vary depending on the patient’s age:
This virus may be transmitted in two ways:
The preventive measures to avoid transmission of the virus are:
Admission to hospital is more likely in infants belonging to high risk groups:
In the above cases, administering prophylaxis with palivizumab is recommended, as it is proven to reduce hospital admissions for RSV.
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