Infective Endocarditis PDF

Infective endocarditis Def: A disesae caused by microbial infection that: -Affects the native heart valves or prosthetic valve -Affects endothelial lining of a cardiac chamber or blood vessel. Pathophysiology: Occurs due to bacteremia + endothelial injury secondary to presence of high veloci...

Infective endocarditis Def: A disesae caused by microbial infection that: -Affects the native heart valves or prosthetic valve -Affects endothelial lining of a cardiac chamber or blood vessel. Pathophysiology: Occurs due to bacteremia + endothelial injury secondary to presence of high velocity jet on predisposed endocardial lining e.g: MR, AR or VSD. Causative organisms: Usually caused by bacterium but may be rickettsia, chlamydia or fungus.  Clinically may be present by: -High grade persistent fever (>5 days) not responding to a usual antibiotic therapy without obvious cause. - Prominent or changing heart murmur. - Acute heart failure. - Acute embolic events like CVS or acute limb ischemia -Or renal failure as a complication of 19 20 21  Management Must be hospitalized and lines of treatment are:- A) Medical treatment: start with empirical antibiotic therapy: Penicillin + gentamycin injections until results of blood culture then culture based antibiotic treatment. Lasts for 4-6 weeks according to type of organism but may extend up to months in special cases like Q fever or brucellosis taking care of antibiotic side effects (e.g renal failure with gentamycin or allergy with penicillin). B) Surgical ttt: For cardiac valves affection: e.g mitral or aortic valve replacement if mitral or aortic endocarditis or local complications like aortic root abscess. Treatment of complications: e.g embolectomy if peripheral embolization occured. 22 Thank You