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Infective Endocarditis

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Handbook of Inpatient Cardiology
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Abstract

Infectious endocarditis, though relatively infrequent, remains a life-threatening infection that occurs across the spectrum of patient age, race, and sex. Some physical findings are classic, though most diagnoses are made in the setting of high clinical suspicion prompting blood cultures and echocardiography. Common pathogens causing infective endocarditis include S. aureus, streptococci, coagulase-negative staphylococci, and gram-negative bacilli (including the HACEK organisms). Empiric antibiotic therapy for infective endocarditis should begin only after blood cultures are drawn to ensure that the causative organism can be identified and subsequently targeted for treatment. Approximately 50% of all patients with infective endocarditis may require some form of surgical intervention.

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References

  1. Duval X, Delahaye F, Alla F, Tattevin P, Obadia JF, Le Moing V, Doco-Lecompte T, Celard M, Poyart C, Strady C, Chirouze C, Bes M, Cambau E, Iung B, Selton-Suty C, Hoen B, AEPEI Study Group. Temporal trends in infective endocarditis in the context of prophylaxis guideline modifications: three successive population-based surveys. J Am Coll Cardiol. 2012;59:1968–76. https://doi.org/10.1016/j.jacc.2012.02.029.

    Article  PubMed  Google Scholar 

  2. Fowler VG Jr, Sanders LL, Kong LK, McClelland RS, Gottlieb GS, Li J, Ryan T, Sexton DJ, Roussakis G, Harrell LJ, Corey GR. Infective endocarditis due to S. aureus: 59 prospectively identified cases with follow-up. Clin Infect Dis. 1999;28:106–14. https://doi.org/10.1086/515076.

    Article  PubMed  Google Scholar 

  3. Baddour LM, Wilson WR, Bayer AS, et al. Infective endocarditis in adults: diagnosis, antimicrobial therapy, and management of complications: a scientific statement for healthcare professionals from the American Heart Association. Circulation. 2015;132(15):1435–86.

    Article  CAS  Google Scholar 

  4. Werner M, Andersson R, Olaison L, Hogevik H. A clinical study of culture-negative endocarditis. Medicine (Baltimore). 2003;82:263–73. https://doi.org/10.1097/01.md.0000085056.63483.d2.

    Article  Google Scholar 

  5. Hoen B, Selton-Suty C, Lacassin F, Etienne J, Briançon S, Leport C, Canton P. Infective endocarditis in patients with negative blood cultures: analysis of 88 cases from a one-year nationwide survey in France. Clin Infect Dis. 1995;20:501–6.

    Article  CAS  Google Scholar 

  6. Pazin GJ, Saul S, Thompson ME. Blood culture positivity: suppression by outpatient antibiotic therapy in patients with bacterial endocarditis. Arch Intern Med. 1982;142:263–8.

    CAS  PubMed  Google Scholar 

  7. Andrews MM, von Reyn CF. Patient selection criteria and management guidelines for outpatient parenteral antibiotic therapy for native valve infective endocarditis. Clin Infect Dis. 33:203–9. https://doi.org/10.1086/321814.

  8. Durack DT, Beeson PB. Experimental bacterial endocarditis, II: survival of a bacteria in endocardial vegetations. Br J Exp Pathol. 1972;53:50–3.

    CAS  PubMed  PubMed Central  Google Scholar 

  9. Dworkin RJ, Lee BL, Sande MA, Chambers HF. Treatment of right-sided S. aureus endocarditis in intravenous drug users with ciprofloxacin and rifampicin. Lancet. 1989;2:1071–3.

    Article  CAS  Google Scholar 

  10. Lefort A, Mainardi JL, Selton-Suty C, Casassus P, Guillevin L, Lortholary O. Streptococcus pneumoniae endocarditis in adults: a multicenter study in France in the era of penicillin resistance (1991-1998): the Pneumococcal Endocarditis Study Group. Medicine (Baltimore). 2000;79:327–37.

    Article  CAS  Google Scholar 

  11. Geraci JE, Wilson WR. Symposium on infective endocarditis, III: endocarditis due to Gram-negative bacteria: report of 56 cases. Mayo Clin Proc. 1982;57:145–8.

    CAS  PubMed  Google Scholar 

  12. Sanfilippo AJ, Picard MH, Newell JB, Rosas E, Davidoff R, Thomas JD, Weyman AE. Echocardiographic assessment of patients with infectious endocarditis: prediction of risk for complications. J Am Coll Cardiol. 1991;18:1191–9.

    Article  CAS  Google Scholar 

  13. Heiro M, Nikoskelainen J, Engblom E, Kotilainen E, Marttila R, Kotilainen P. Neurologic manifestations of infective endocarditis: a 17-year experience in a teaching hospital in Finland. Arch Intern Med. 2000;160:2781–7.

    Article  CAS  Google Scholar 

  14. Steckelberg JM, Murphy JG, Ballard D, Bailey K, Tajik AJ, Taliercio CP, Giuliani ER, Wilson WR. Emboli in infective endocarditis: the prognostic value of echocardiography. Ann Intern Med. 1991;114:635–40. https://doi.org/10.7326/0003-4819-114-8-635.

    Article  CAS  PubMed  Google Scholar 

  15. Hess A, Klein I, Iung B, et al. Brain MRI findings in neurologically asymptomatic patients with infective endocarditis. AJNR Am J Neuroradiol. 2013;34:1579–84.

    Article  CAS  Google Scholar 

  16. Carpenter JL. Perivalvular extension of infection in patients with infectious endocarditis. Rev Infect Dis. 1991;13:127–38.

    Article  CAS  Google Scholar 

  17. Blumberg EA, Karalis DA, Chandrasekaran K, Wahl JM, Vilaro J, Covalesky VA, Mintz GS. Endocarditis-associated paravalvular abscesses: do clinical parameters predict the presence of abscess? Chest. 1995;107:898–903.

    Article  CAS  Google Scholar 

  18. Daniel WG, Mügge A, Martin RP, Lindert O, Hausmann D, Nonnast-Daniel B, Laas J, Lichtlen PR. Improvement in the diagnosis of abscesses associated with endocarditis by transesophageal echocardiography. N Engl J Med. 1991;324:795–800. https://doi.org/10.1056/NEJM199103213241203.

    Article  CAS  PubMed  Google Scholar 

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Correspondence to John Ricketts .

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Ricketts, J., Jacob, J.T. (2020). Infective Endocarditis. In: Wells, B., Quintero, P., Southmayd, G. (eds) Handbook of Inpatient Cardiology. Springer, Cham. https://doi.org/10.1007/978-3-030-47868-1_15

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  • DOI: https://doi.org/10.1007/978-3-030-47868-1_15

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  • Online ISBN: 978-3-030-47868-1

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