Infective Endocarditis | Anatomy2Medicine
Infective Endocarditis Symptoms

Infective Endocarditis

    • Acute infective endocarditis
      • a fulminant disease.
  • causative organism is usually Staphylococcus aureus.(MCQ)
  • It may present as an invasive infection with myocardial abscess or valve destruction.
  • Subacute infective endocarditis
      • has a slower clinical course.
      • can present insidiously, sometimes as just a low-grade fever.
      • The causative organisms are less virulent and include: .(MCQ)
  • Viridans streptococci
  • Streptococcus bovis
  • Enterococci
    • Haemophilus parainfluenzae, Haemophilus aphrophilus, Actinobacillus, Cardiobacterium, Eikenella, and Kingella (HACEK) .(MCQ)
      • HACEK organisms
        • very difficult to isolate
        • categorized as “culture negative,” .(MCQ)
        • they are now recognized as fastidious and slow growing.
  • “culture negative” infective endocarditis
      • fever, valve disease, vegetations on echocardiography, with or without emboli, and negative culture
  • usually caused by Coxiella burnetii and Bartonella species. .(MCQ)
    • Duke criteria —  for making the diagnosis of infective endocarditis.
      • Major criteria .(MCQ)
        • Continuous bacteremia with an organism that typically causes infective endocarditis
        • A new or worsening regurgitant murmur
        • Vegetations visualized by echocardiography
      • Minor criteria .(MCQ)
  • Fever
        • Blood cultures showing an uncharacteristic organism
        • Echocardiographic findings consistent with the diagnosis but not meeting major criteria
        • Embolic phenomena, such as septic infarcts
  • Immunologic phenomena, such as glomerulonephritis, or a positive rheumatoid factor
      • To make a diagnosis of infective endocarditis using the Duke criteria, the patient should meet two major criteria, one major and three minor criteria, or all five minor criteria. .(MCQ)
    • Marantic endocarditis or nonbacterial thrombotic endocarditis
  • characterized by small vegetations consisting of platelets, fibrin, and leukocytes on the valve leaflets.
  • vegetations are sterile and nondestructive. .(MCQ)
    • associated with malignancy or sepsis. .(MCQ)
  • Emboli from the vegetations are common, resulting in infarction of involved organs.
  • A thrombophilic state is thought to be the mechanism
  • there is usually accompanying venous thrombosis and pulmonary emboli.
  • Trousseau syndrome.(MCQ)
  • a hypercoagulable state with chronic disseminated intravascular coagulation (DIC) and migratory thrombophlebitis
  • often seen in mucinous adenocarcinomas.
    • Libman-Sacks endocarditis .(MCQ)
      • associated with systemic lupus erythematosus (SLE). .(MCQ)
      • Mitral or tricuspid valvulitis
      • lead to development of sterile vegetations .(MCQ)
  • consist of fibrinous material and “hematoxylin bodies.”
  • Unlike the other forms of endocarditis, these vegetations can occur on both sides of the valve. .(MCQ)