INFECTIVE ENDOCARDITIS

Definition
Endovascular infection of -
• Cardiovascular structure,
• Cardiac valves,
• Atrial & Ventricular endocardium,
• Large intrathoracic vessels & Intracardiac foreign bodies [e.g.- Prosthetic valves, Pacemaker and surgical conduits ], Called infective endocarditis.

Which patients affected by endocarditis?
♦Previously normal valves [50% - typically acute presentation]
♦Rheumatic valve disease [30%]
♦Prosthetic valves
♦Congenital heart defects
♦Intravenous drug users [IVDUs, e.g. typically causing tricuspid lesion]

Causes of infective endocarditis
♦Streptococcus viridians [most common cause 40-50%]
♦Streptococcus bovis [associated with colorectal cancer]
♦Staphylococcus epidermidis [especially prosthetic valves]
♦Staphylococcus aureus [IVDUs, especially acute presentation]
♦Non-infective: Systemic lupus erythematous & Malignancy: Marantic endocarditis

Culture negative – causes [ABC HACEK]
♦ A- Antibiotic therapy
♦ B- Bartonella
♦ B- Brucella
♦ C- Coxiella burnetii
♦ HACEK- Haemophilius, Actinobacillus, Cardiobacterium, Eikenella, Kingella

Lab investigation of infective endocarditis
• Blood culture
• Serological tests
• Full blood count
• Urea & electrolyte
• Liver biochemistry
• Inflammatory markers
• Urine
• Polymerase chain reaction (PCR)
• Electrocardiogram
• Echocardiography
• Chest X-ray

Ref: passmedicine MRCP

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