Endocarditis is an infection of the inner lining of the heart caused by bacteria. It most commonly affects prosthetic heart valves, those with intravenous drug use, and those with mitral valve prolapse. Complications include destructive effects on heart valves, embolization of infected material to other parts of the body, hematologic seeding of remote sites, and complications from the body's chronic immune response. Diagnosis involves a high index of suspicion based on symptoms like fever and new heart murmurs, positive blood cultures, and visible vegetations on heart valves seen via echocardiogram. Treatment consists of intravenous antibiotics for an average of 6 weeks along with potential surgical excision of infected heart valves, especially for refractory bact
Endocarditis is an infection of the inner lining of the heart caused by bacteria. It most commonly affects prosthetic heart valves, those with intravenous drug use, and those with mitral valve prolapse. Complications include destructive effects on heart valves, embolization of infected material to other parts of the body, hematologic seeding of remote sites, and complications from the body's chronic immune response. Diagnosis involves a high index of suspicion based on symptoms like fever and new heart murmurs, positive blood cultures, and visible vegetations on heart valves seen via echocardiogram. Treatment consists of intravenous antibiotics for an average of 6 weeks along with potential surgical excision of infected heart valves, especially for refractory bact
Endocarditis is an infection of the inner lining of the heart caused by bacteria. It most commonly affects prosthetic heart valves, those with intravenous drug use, and those with mitral valve prolapse. Complications include destructive effects on heart valves, embolization of infected material to other parts of the body, hematologic seeding of remote sites, and complications from the body's chronic immune response. Diagnosis involves a high index of suspicion based on symptoms like fever and new heart murmurs, positive blood cultures, and visible vegetations on heart valves seen via echocardiogram. Treatment consists of intravenous antibiotics for an average of 6 weeks along with potential surgical excision of infected heart valves, especially for refractory bact
Epidemiology Clinical Features Diagnosis Treatment
Endocarditis Prosthetic valves Complications: High index of suspicion Antibiotics (bacteriocidal
(greatest overall) - local destructive and bacteriostatic); IV, 6 Injury to endothelium effects of bacteria Positive blood cultures weeks avg. - high velocity jet IV drug use: (greatest - embolization impacting on individual) - hematologic Visible vegetations Surgical excision surface seeding of remote (refractory bacteremia, - flow from high to MVP (most common sites New valvular regurg severe valve distruction, low pressure area structural abnormality - chronic Ab emboli, large vegetations, - flow through associated) response Minor: persistent fever, perivalvular abscess) narrow orifice vascular phenomena, Rheumatic Heart Disease Fever immunologic, thickened Antibiotic prophylaxis Bacterial resistance to valves on echo (prevention): valvular immunity Congenital Cardiac New murmur stenosis or regurg; VSD, Abnormalities: PDA, 2 major or 1 major and 3 valve replacement, MVP Platelet adherence and ventriculoseptal defect, Splenomegaly minor criteria w/ regurg; prior initiation of clotting bicuspid aortic valve endocarditis cascade Petechiae Labs: blood cultures, Microbiology: rheumatoid factor, - S. viridans Splinter hemorrhages anemia or chonic disease (overall) - S. aureus (IV drug Oslers nodes Echo: valve vegetations, abuse) perivalvular abcess - S. epidermidis Musculoskeletal (valve surgery symptoms 1st 60 days) Systemic emboli