Endocarditis infecciosa

Abstract

Infective endocarditis (IE) has high morbidity and mortality and requires early diagnosis and treatment. It is the result of bacteraemia, with subsequent anchorage, colonisation, and vegetation formation. Its course can be acute, subacute, or chronic, depending on the aggressiveness of the micro-organism involved. The three most common pathogens are staphylococci, streptococci, and enterococci. It is more common in males, in older patients and patients with predisposing heart disease or valvular heart disease. It should be suspected if there is fever without a focus, especially if accompanied by new onset murmur, embolic or immunological phenomena. Diagnosis is still based on Duke criteria. Microbiological isolation by blood culture or serology and imaging tests, mainly echocardiography, constitute the mainstay of diagnosis. Empirical antibiotic treatment should be given early and later adjusted according to the results of the antibiogram. Heart surgery should not be delayed in the event of complications or poor progression.