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Diagnostic Criteria for Infective Endocarditis

  • Franck Thuny
Chapter

Abstract

Diagnosis of infective endocarditis usually relies on the association of an infectious syndrome and a recent endocardial involvement. This association is the cornerstone of the successive diagnostic criteria proposed to facilitate the difficult diagnosis of the disease. During the past decades these classifications have been modified with the progress of the microbiological testing and the cardiac imaging techniques. Recently, the 2015 Guidelines of European Society of Cardiology have proposed new diagnostic criteria, which implemented new imaging modalities for improving diagnostic yield. The identification of paravalvular lesions by cardiac computed tomography and, the in the setting of suspicion of endocarditis on a prosthetic valve, an abnormal activity around the site of implantation detected by 18F-FDG PET/CT or radiolabelled leukocytes SPECT/CT are now considered as a major criterion. Moreover, the identification of recent embolic events or infectious aneurysms only by imaging (silent events) is now considered as a minor criterion.

Keywords

Blood cultures Echocardiography Cardiac imaging Positron emission tomography Cardiac computed tomography Magnetic resonance imaging 

References

  1. 1.
    von Reyn FC, Arbeit RD, Friedland GH, et al. Criteria for the diagnosis of infective endocarditis. Clin Infect Dis. 1994;19:368–70.CrossRefGoogle Scholar
  2. 2.
    Durack DT, Lukes AS, Bright DK. New criteria for diagnosis of infective endocarditis: utilization of specific echocardiographic findings. Duke endocarditis service. Am J Med. 1994;96:200–9.CrossRefPubMedGoogle Scholar
  3. 3.
    Li JS, Sexton DJ, Mick N, et al. Proposed modifications to the duke criteria for the diagnosis of infective endocarditis. Clin Infect Dis. 2000;30:633–8.CrossRefPubMedGoogle Scholar
  4. 4.
    Habib G, Derumeaux G, Avierinos JF, et al. Value and limitations of the duke criteria for the diagnosis of infective endocarditis. J Am Coll Cardiol. 1999;33:2023–9.CrossRefPubMedGoogle Scholar
  5. 5.
    Hill EE, Herijgers P, Claus P, et al. Abscess in infective endocarditis: the value of transesophageal echocardiography and outcome: a 5-year study. Am Heart J. 2007;154:923–8.CrossRefPubMedGoogle Scholar
  6. 6.
    Vieira ML, Grinberg M, Pomerantzeff PM, et al. Repeated echocardiographic examinations of patients with suspected infective endocarditis. Heart. 2004;90:1020–4.CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Thuny F, Grisoli D, Collart F, et al. Management of infective endocarditis: challenges and perspectives. Lancet. 2012;379:965–75.CrossRefPubMedGoogle Scholar
  8. 8.
    Thuny F, Gaubert JY, Jacquier A, et al. Imaging investigations in infective endocarditis: current approach and perspectives. Arch Cardiovasc Dis. 2013;106:52–62.CrossRefPubMedGoogle Scholar
  9. 9.
    Bruun NE, Habib G, Thuny F, et al. Cardiac imaging in infectious endocarditis. Eur Heart J. 2014;35:624–32.CrossRefPubMedGoogle Scholar
  10. 10.
    Feuchtner GM, Stolzmann P, Dichtl W, et al. Multislice computed tomography in infective endocarditis: comparison with transesophageal echocardiography and intraoperative findings. J Am Coll Cardiol. 2009;53:436–44.CrossRefPubMedGoogle Scholar
  11. 11.
    Fagman E, Perrotta S, Bech-Hanssen O, et al. Ecg-gated computed tomography: a new role for patients with suspected aortic prosthetic valve endocarditis. Eur Radiol. 2012;22:2407–14.CrossRefPubMedGoogle Scholar
  12. 12.
    Snygg-Martin U, Gustafsson L, Rosengren L, et al. Cerebrovascular complications in patients with left-sided infective endocarditis are common: a prospective study using magnetic resonance imaging and neurochemical brain damage markers. Clin Infect Dis. 2008;47:23–30.CrossRefPubMedGoogle Scholar
  13. 13.
    Cooper HA, Thompson EC, Laureno R, et al. Subclinical brain embolization in left-sided infective endocarditis: results from the evaluation by mri of the brains of patients with left-sided intracardiac solid masses (embolism) pilot study. Circulation. 2009;120:585–91.CrossRefPubMedGoogle Scholar
  14. 14.
    Duval X, Iung B, Klein I, et al. Effect of early cerebral magnetic resonance imaging on clinical decisions in infective endocarditis: a prospective study. Ann Intern Med. 2010;152:497–504.CrossRefPubMedGoogle Scholar
  15. 15.
    Iung B, Klein I, Mourvillier B, et al. Respective effects of early cerebral and abdominal magnetic resonance imaging on clinical decisions in infective endocarditis. Eur Heart J Cardiovasc Imaging. 2012;13:703–10.CrossRefPubMedGoogle Scholar
  16. 16.
    Saby L, Le Dolley Y, Laas O, et al. Early diagnosis of abscess in aortic bioprosthetic valve by 18f-fluorodeoxyglucose positron emission tomography-computed tomography. Circulation. 2012;126:e217–20.CrossRefPubMedGoogle Scholar
  17. 17.
    Saby L, Laas O, Habib G, et al. Positron emission tomography/computed tomography for diagnosis of prosthetic valve endocarditis: increased valvular (18)f-fluorodeoxyglucose uptake as a novel major criterion. J Am Coll Cardiol. 2013;61:2374–82.CrossRefPubMedGoogle Scholar
  18. 18.
    Erba PA, Conti U, Lazzeri E, et al. Added value of 99mtc-hmpao-labeled leukocyte spect/ct in the characterization and management of patients with infectious endocarditis. J Nucl Med. 2012;53:1235–43.CrossRefPubMedGoogle Scholar
  19. 19.
    Gahide G, Bommart S, Demaria R, et al. Preoperative evaluation in aortic endocarditis: findings on cardiac CT. AJR Am J Roentgenol. 2010;194:574–8.CrossRefPubMedGoogle Scholar
  20. 20.
    Thuny F, Avierinos JF, Tribouilloy C, et al. Impact of cerebrovascular complications on mortality and neurologic outcome during infective endocarditis: a prospective multicentre study. Eur Heart J. 2007;28:1155–61.CrossRefPubMedGoogle Scholar
  21. 21.
    Bensimhon L, Lavergne T, Hugonnet F, et al. Whole body [(18) f]fluorodeoxyglucose positron emission tomography imaging for the diagnosis of pacemaker or implantable cardioverter defibrillator infection: a preliminary prospective study. Clin Microbiol Infect. 2010;17:836–44.CrossRefPubMedGoogle Scholar
  22. 22.
    Sarrazin JF, Philippon F, Tessier M, et al. Usefulness of fluorine-18 positron emission tomography/computed tomography for identification of cardiovascular implantable electronic device infections. J Am Coll Cardiol. 2012;59:1616–25.CrossRefPubMedGoogle Scholar
  23. 23.
    Habib G, et al. 2015 ESC guidelines for the management of infective endocarditis. The task force for the management of infective endocarditis of the European Society of Cardiology (ESC). Eur Heart J. 2015;36(44):3075–128.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  1. 1.Unit of Heart Failure and Valve Heart DiseaseNord HospitalMarseilleFrance

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