Endocarditis: Difference between revisions
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[[File:Histopathology of vegetation of bacterial endocarditis.jpg|Histopathology of vegetation of bacterial endocarditis|thumb]] | {{SI}} | ||
{{Infobox medical condition | |||
| name = Endocarditis | |||
| image = [[File:Blood_culture_negative_endocarditis.jpg|250px]] | |||
| caption = Blood culture negative endocarditis | |||
| field = [[Cardiology]], [[Infectious disease]] | |||
| symptoms = [[Fever]], [[heart murmur]], [[fatigue]], [[night sweats]], [[shortness of breath]], [[chest pain]] | |||
| complications = [[Heart failure]], [[stroke]], [[sepsis]], [[glomerulonephritis]] | |||
| onset = Gradual or sudden | |||
| duration = Weeks to months | |||
| causes = [[Bacterial infection]], [[fungal infection]] | |||
| risks = [[Heart valve disease]], [[congenital heart defect]], [[intravenous drug use]], [[prosthetic heart valve]] | |||
| diagnosis = [[Blood culture]], [[echocardiogram]], [[CT scan]], [[MRI]] | |||
| differential = [[Myocarditis]], [[pericarditis]], [[rheumatic fever]] | |||
| treatment = [[Antibiotics]], [[surgery]] | |||
| medication = [[Penicillin]], [[vancomycin]], [[gentamicin]] | |||
| prognosis = Variable, depends on cause and treatment | |||
| frequency = 3 to 10 per 100,000 people per year | |||
| deaths = 20% to 25% mortality rate | |||
}} | |||
[[File:Histopathology of vegetation of bacterial endocarditis.jpg|Histopathology of vegetation of bacterial endocarditis|left|thumb]] | |||
'''Endocarditis''' is an inflammatory pathology that predominantly impacts the endocardium, the inner lining of the heart. Though primarily stemming from bacterial sources, various other microorganisms or non-infectious triggers can induce this condition. Predominantly, heart valves become the focal point of this ailment, with a potential escalation to critical complications if not addressed in due time.<ref>{{cite journal|last=Baddour|first=LM|title=Infective Endocarditis in Adults: Diagnosis, Antimicrobial Therapy, and Management of Complications|journal=Circulation|year=2015|pmid=26373316|doi=10.1161/CIR.0000000000000296}}</ref> | '''Endocarditis''' is an inflammatory pathology that predominantly impacts the endocardium, the inner lining of the heart. Though primarily stemming from bacterial sources, various other microorganisms or non-infectious triggers can induce this condition. Predominantly, heart valves become the focal point of this ailment, with a potential escalation to critical complications if not addressed in due time.<ref>{{cite journal|last=Baddour|first=LM|title=Infective Endocarditis in Adults: Diagnosis, Antimicrobial Therapy, and Management of Complications|journal=Circulation|year=2015|pmid=26373316|doi=10.1161/CIR.0000000000000296}}</ref> | ||
== Etiology and Predisposing Factors == <!--T:2--> | == Etiology and Predisposing Factors == <!--T:2--> | ||
Endocarditis can manifest from a myriad of microorganisms; however, bacteria such as ''streptococci'', ''staphylococci'', and ''enterococci'' are the most frequent culprits. A subtype, termed non-infective endocarditis, arises without concurrent infection, influenced by factors like lupus, cancer, or specific drug usage.<ref>{{cite journal|last=Falcone|first=M|title=Infective endocarditis: a review of etiology and diagnosis|journal=Current Infectious Disease Reports|year=2019|pmid=30919142|doi=10.1007/s11908-019-0671-4}}</ref> Predisposing factors include the presence of prosthetic heart valves, prior endocarditis episodes, congenital heart anomalies, and intravenous drug utilization. | Endocarditis can manifest from a myriad of microorganisms; however, bacteria such as ''streptococci'', ''staphylococci'', and ''enterococci'' are the most frequent culprits. A subtype, termed non-infective endocarditis, arises without concurrent infection, influenced by factors like lupus, cancer, or specific drug usage.<ref>{{cite journal|last=Falcone|first=M|title=Infective endocarditis: a review of etiology and diagnosis|journal=Current Infectious Disease Reports|year=2019|pmid=30919142|doi=10.1007/s11908-019-0671-4}}</ref> Predisposing factors include the presence of prosthetic heart valves, prior endocarditis episodes, congenital heart anomalies, and intravenous drug utilization. | ||
== Clinical Manifestations and Potential Complications == | |||
== Clinical Manifestations and Potential Complications == | |||
Clinical manifestations span a spectrum from fever, fatigue, weight loss, night sweats, to the auditory sign of a heart murmur. As the pathology advances, graver signs such as heart failure might surface. Complications encompass heart valve deterioration, heart failure, cerebral events like stroke, and systemic embolism.<ref>{{cite journal|last=Thuny|first=F|title=Risk of embolism and death in infective endocarditis: prognostic value of echocardiography: a prospective multicenter study|journal=Circulation|year=2005|pmid=16027258|doi=10.1161/CIRCULATIONAHA.104.493155}}</ref> | Clinical manifestations span a spectrum from fever, fatigue, weight loss, night sweats, to the auditory sign of a heart murmur. As the pathology advances, graver signs such as heart failure might surface. Complications encompass heart valve deterioration, heart failure, cerebral events like stroke, and systemic embolism.<ref>{{cite journal|last=Thuny|first=F|title=Risk of embolism and death in infective endocarditis: prognostic value of echocardiography: a prospective multicenter study|journal=Circulation|year=2005|pmid=16027258|doi=10.1161/CIRCULATIONAHA.104.493155}}</ref> | ||
== Diagnostic Approach and Therapeutic Interventions == | |||
== Diagnostic Approach and Therapeutic Interventions == | |||
For diagnosis, clinicians commonly resort to blood cultures to identify causative agents and employ imaging modalities like echocardiography for detailed visualization of heart valves. A well-established set of criteria, the Duke Criteria, amalgamates clinical, laboratory, and echocardiographic data for a conclusive diagnosis.<ref>{{cite journal|last=Li|first=JS|title=Proposed modifications to the Duke criteria for the diagnosis of infective endocarditis|journal=Clinical Infectious Diseases|year=2000|pmid=10770721|doi=10.1086/313753}}</ref> | For diagnosis, clinicians commonly resort to blood cultures to identify causative agents and employ imaging modalities like echocardiography for detailed visualization of heart valves. A well-established set of criteria, the Duke Criteria, amalgamates clinical, laboratory, and echocardiographic data for a conclusive diagnosis.<ref>{{cite journal|last=Li|first=JS|title=Proposed modifications to the Duke criteria for the diagnosis of infective endocarditis|journal=Clinical Infectious Diseases|year=2000|pmid=10770721|doi=10.1086/313753}}</ref> | ||
Treatment paradigms primarily involve prolonged antibiotic regimens, often necessitating in-patient care. In scenarios where antibiotics fail or the disease severity escalates, surgical interventions to repair or supplant damaged heart valves might be imperative.<ref>{{cite journal|last=Wang|first=A|title=Contemporary clinical profile and outcome of prosthetic valve endocarditis|journal=Journal of the American Medical Association|year=2007|pmid=17389203|doi=10.1001/jama.297.12.1354}}</ref> | Treatment paradigms primarily involve prolonged antibiotic regimens, often necessitating in-patient care. In scenarios where antibiotics fail or the disease severity escalates, surgical interventions to repair or supplant damaged heart valves might be imperative.<ref>{{cite journal|last=Wang|first=A|title=Contemporary clinical profile and outcome of prosthetic valve endocarditis|journal=Journal of the American Medical Association|year=2007|pmid=17389203|doi=10.1001/jama.297.12.1354}}</ref> | ||
== Prophylaxis == | |||
== Prophylaxis == | |||
To thwart the onset of endocarditis, it is advisable to maintain dental hygiene and undergo periodic dental examinations since dental infections can be a precursor to endocarditis. Certain high-risk cohorts might also necessitate antibiotic prophylaxis prior to specific dental or surgical ventures.<ref>{{cite journal|last=Wilson|first=W|title=Prevention of infective endocarditis: guidelines from the American Heart Association|journal=Circulation|year=2007|pmid=17446442|doi=10.1161/CIRCULATIONAHA.106.183095}}</ref> | To thwart the onset of endocarditis, it is advisable to maintain dental hygiene and undergo periodic dental examinations since dental infections can be a precursor to endocarditis. Certain high-risk cohorts might also necessitate antibiotic prophylaxis prior to specific dental or surgical ventures.<ref>{{cite journal|last=Wilson|first=W|title=Prevention of infective endocarditis: guidelines from the American Heart Association|journal=Circulation|year=2007|pmid=17446442|doi=10.1161/CIRCULATIONAHA.106.183095}}</ref> | ||
== Related Topics == | |||
== Related Topics == | |||
* [[Carditis]] | * [[Carditis]] | ||
* [[Myocarditis]] | * [[Myocarditis]] | ||
* [[Pericarditis]] | * [[Pericarditis]] | ||
== Bibliography == | |||
== Bibliography == | |||
{{reflist}} | {{reflist}} | ||
{{stub}} | {{stub}} | ||
Revision as of 16:28, 6 April 2025
Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD's medical weight loss NYC, sleep center NYC
Philadelphia medical weight loss and Philadelphia sleep clinics
| Endocarditis | |
|---|---|
| |
| Synonyms | N/A |
| Pronounce | N/A |
| Specialty | N/A |
| Symptoms | Fever, heart murmur, fatigue, night sweats, shortness of breath, chest pain |
| Complications | Heart failure, stroke, sepsis, glomerulonephritis |
| Onset | Gradual or sudden |
| Duration | Weeks to months |
| Types | N/A |
| Causes | Bacterial infection, fungal infection |
| Risks | Heart valve disease, congenital heart defect, intravenous drug use, prosthetic heart valve |
| Diagnosis | Blood culture, echocardiogram, CT scan, MRI |
| Differential diagnosis | Myocarditis, pericarditis, rheumatic fever |
| Prevention | N/A |
| Treatment | Antibiotics, surgery |
| Medication | Penicillin, vancomycin, gentamicin |
| Prognosis | Variable, depends on cause and treatment |
| Frequency | 3 to 10 per 100,000 people per year |
| Deaths | 20% to 25% mortality rate |
Endocarditis is an inflammatory pathology that predominantly impacts the endocardium, the inner lining of the heart. Though primarily stemming from bacterial sources, various other microorganisms or non-infectious triggers can induce this condition. Predominantly, heart valves become the focal point of this ailment, with a potential escalation to critical complications if not addressed in due time.<ref>Baddour, LM,
Infective Endocarditis in Adults: Diagnosis, Antimicrobial Therapy, and Management of Complications, Circulation, 2015, DOI: 10.1161/CIR.0000000000000296, PMID: 26373316,</ref>
Etiology and Predisposing Factors
Endocarditis can manifest from a myriad of microorganisms; however, bacteria such as streptococci, staphylococci, and enterococci are the most frequent culprits. A subtype, termed non-infective endocarditis, arises without concurrent infection, influenced by factors like lupus, cancer, or specific drug usage.<ref>Falcone, M,
Infective endocarditis: a review of etiology and diagnosis, Current Infectious Disease Reports, 2019, DOI: 10.1007/s11908-019-0671-4, PMID: 30919142,</ref> Predisposing factors include the presence of prosthetic heart valves, prior endocarditis episodes, congenital heart anomalies, and intravenous drug utilization.
Clinical Manifestations and Potential Complications
Clinical manifestations span a spectrum from fever, fatigue, weight loss, night sweats, to the auditory sign of a heart murmur. As the pathology advances, graver signs such as heart failure might surface. Complications encompass heart valve deterioration, heart failure, cerebral events like stroke, and systemic embolism.<ref>Thuny, F,
Risk of embolism and death in infective endocarditis: prognostic value of echocardiography: a prospective multicenter study, Circulation, 2005, DOI: 10.1161/CIRCULATIONAHA.104.493155, PMID: 16027258,</ref>
Diagnostic Approach and Therapeutic Interventions
For diagnosis, clinicians commonly resort to blood cultures to identify causative agents and employ imaging modalities like echocardiography for detailed visualization of heart valves. A well-established set of criteria, the Duke Criteria, amalgamates clinical, laboratory, and echocardiographic data for a conclusive diagnosis.<ref>Li, JS,
Proposed modifications to the Duke criteria for the diagnosis of infective endocarditis, Clinical Infectious Diseases, 2000, DOI: 10.1086/313753, PMID: 10770721,</ref>
Treatment paradigms primarily involve prolonged antibiotic regimens, often necessitating in-patient care. In scenarios where antibiotics fail or the disease severity escalates, surgical interventions to repair or supplant damaged heart valves might be imperative.<ref>Wang, A,
Contemporary clinical profile and outcome of prosthetic valve endocarditis, Journal of the American Medical Association, 2007, DOI: 10.1001/jama.297.12.1354, PMID: 17389203,</ref>
Prophylaxis
To thwart the onset of endocarditis, it is advisable to maintain dental hygiene and undergo periodic dental examinations since dental infections can be a precursor to endocarditis. Certain high-risk cohorts might also necessitate antibiotic prophylaxis prior to specific dental or surgical ventures.<ref>Wilson, W,
Prevention of infective endocarditis: guidelines from the American Heart Association, Circulation, 2007, DOI: 10.1161/CIRCULATIONAHA.106.183095, PMID: 17446442,</ref>
Related Topics
Bibliography
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