cardiovascular disorders
Infective Endocarditis
Introduction
Infective endocarditis is infection of the endocardium, usually with bacteria (commonly, streptococci or staphylococci) or fungi. It may cause fever, heart murmurs, petechiae, anemia, embolic phenomena, and endocardial vegetations. Vegetations may result in valvular incompetence or obstruction, myocardial abscess, or mycotic aneurysm. Diagnosis requires demonstration of microorganisms in blood and usually echocardiography. Treatment consists of prolonged antimicrobial treatment and sometimes surgery. Endocarditis usually refers to infection of the endocardium (ie, infective endocarditis). The term can also include Noninfective Endocarditis , in which sterile platelet and fibrin thrombi form on cardiac valves and adjacent endocardium. Noninfective endocarditis sometimes leads to infective endocarditis. Both can result in embolization and impaired cardiac function. The diagnosis of infective endocarditis is usually based on a constellation of clinical findings rather than a single definitive test result. Infective endocarditis can occur at any age. Men are affected about twice as often as women. Incidence of infection and mortality increase with increasing age. Patients who use illicit intravenous drugs, immunocompromised patients, patients with prosthetic heart valves and other intracardiac devices are at highest risk. There is also an increased risk in patients with indwelling intravascular catheters. 