Infective Endocarditis Diagnosis and Management
Abstract
Background: Infective endocarditis (IE) is a microbial (usually bacteria) infection affecting the heart tissue or the adjacent vascular endothelium. The blood-circulating microbes usually need to be available in a certain inoculum to allow invasion and thus infect the heart. Moreover, if the valve annulus is affected, the infection will spread into the extravascular areas. The main causative agents in IE are bacteria; however, other causes such as fungi are still a possibility in many cases. The most common bacteria seen are staphylococci and streptococci, and they collectively account for approximately 80% of cases; while S. Aureus, in particular is the most aggressive one. Objectives: We aimed to review the literature regarding the pathophysiology of infective endocarditis, clinical features, risk factors, diagnosis, and management of this disease. Methodology: PubMed database was used for articles selection. Conclusion: Diagnosing of infective endocarditis remains the pivotal step in management of these patients; thus, it had been studied widely for many years. Duke or modified Duke Criteria remain the most famous tool in diagnostic assessment, and they incorporate information from multiple sources into minor and major criteria which will reflect the probability of the disease in the suspected patients. The mainstay treatment of infective endocarditis is intravenous antibiotics, titred to serum levels, and the choice depends on the suspected causative organism and the valve involved in IE being native or prosthetic. Infective endocarditis prophylaxis is still a major point of difference among clinicians. Some institutions advocate for antibiotic prophylaxis in patients undergoing any dental procedure; while, others advised against prophylactic antibiotic.
