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9 - Infective Endocarditis

from Section 2 - Infectious Disease Emergencies

Published online by Cambridge University Press:  02 November 2023

By
Jason M. Block
Edited by
Kaushal Shah  and
Jarone Lee
Edited in association with
Clark G. Owyang  and
Benjamin Christian Renne
Kaushal Shah
Affiliation:
Weill Cornell Medical Center, New York
Jarone Lee
Affiliation:
Massachusetts General Hospital, Boston
Clark G. Owyang
Affiliation:
Weill Cornell Medical Center, New York
Benjamin Christian Renne
Affiliation:
Massachusetts General Hospital, Boston
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Summary

  • Infective endocarditis (IE) is a microbial infection of the endothelial layer of the heart, the valves or both. The mitral valve is most commonly affected, except in patients with intravenous drug use (IVDU), where the tricuspid valve is more commonly affected. Risk factors include age, chronic hemodialysis, poor dentition, valvulopathy, immunocompromised status, diabetes, IVDU, prosthetic valve and implanted cardiac devices. More than 50% of cases of IE occur in patients older than 60 years.

  • The majority of cases are due to Gram-positive cocci such as Staphylococcus and Streptococcus species. In patients with negative blood cultures and no recent antibiotic use, the organisms are often the HACEK group (Haemophilus, Actinobacillus, Cardiobacterium, Eikenella, Kingella). Approximately 50% of patients require surgical management.

Keywords

valveinfectionantibioticsfeverDuke Criteria
Type
Chapter
Information
Practical Emergency Resuscitation and Critical Care , pp. 77 - 82
Publisher: Cambridge University Press
Print publication year: 2023

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References

Marx, JA, Hockberger, RS, Walls, RM, et al., eds. Rosen’s Emergency Medicine: Concepts and Clinical Practice, 9th ed. Philadelphia, PA: Mosby Elsevier, 2018.Google Scholar
Tintinalli, JE, Stapczynski, JS, Cline, DM, et al., eds. Emergency Medicine: A Comprehensive Study Guide, 9th ed. New York, NY: McGraw-Hill Medical, 2016.Google Scholar
Habib, G, Lancellotti, P, Antunes, MJ, 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. Eur Heart J 2015;36(44):3075–3128.CrossRefGoogle ScholarPubMed
Wang, A, Gaca, JG, Chu, VH. Management considerations in infective endocarditis: A review. JAMA 2018;320(1):72–83. https://doi.org/10.1001/jama.2018.7596CrossRefGoogle ScholarPubMed

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