The clinical picture of infectious endocarditis ieits microorganisms, diagnostic criteria duke and modified duke criteria,1,2 involved valve, native versus prosthetic valve, and complicationshas been well described. Vegetations can form because of bacteria adhering to valves, which can then become embolic causing heart attacks or strokes. Infective endocarditis pathophysiology things you didnt. Give three examples of vascular sequelae of infective endocarditis 5. Infective endocarditis ie is a rare, lifethreatening disease that has longlasting effects even among patients who survive and are cured. Worlds best powerpoint templates crystalgraphics offers more powerpoint templates than anyone else in the world, with over 4 million to choose from. The clinical presentation of infective endocarditis is. Discuss the epidemiology and pathogenesis of infective endocarditis. Infective endocarditis is rare, with a yearly incidence of about 310 per 100 000 people.
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. Infection most commonly involves heart valves but may also occur on the lowpressure side of a ventricular septal defect, on mural endocardium damaged by aberrant jets of blood or foreign bodies, or on intracardiac devices themselves. Infective and non infective related causes must be distinguished.
Infective endocarditis results from interactions between the human host and responsible microorganisms. The ability of an organism to cause endocarditis is the result of an interplay between the predisposing structural abnormalities of the cardiac valve for bacterial adherence, the adhesion of circulating bacteria to the valvular surface, and the ability of the. Chambers, md disclosures allergan research grant genentech research grant circulation. Ie disproportionately affects those with underlying structural heart disease and is increasingly associated with health care contact, particularly in patients who have intracardiac prosthetic material. Acute bacterial endocarditis abe is a fulminant illness associated with high fevers, systemic toxicity, and death within days to weeks up to 6wks if untreated. Pathophysiology of infective endocarditis request pdf. Definition of infective endocarditis infective endocarditis, a serious. Infective endocarditis cardiovascular disorders merck. Infective endocarditis ie is a microbial usually bacteria infection affecting the heart tissue or the adjacent vascular endothelium.
Evidence may include fever, small areas of bleeding into skin, heart murmur, feeling tired, and low red blood cell count. Pathophysiology and causes of endocarditis oxford medicine. Positive blood culture for infective endocarditis typical microorganism consistent with ie from 2 separate blood cultures, as noted below viridans streptococci, streptococcus bovis, or hacek group, or communityacquired staphylococcus aureus or enterococci, in the absence of a primary focus. Get more informations through this page inlcuding infective endocarditis ppt, infective endocarditis ppt 2019, infective endocarditis ppt 2018, infective endocarditis ppt for nurses, infective endocarditis ppt download, infective endocarditis ppt 2017, infective endocarditis. Despite advances in medical and surgical therapy, infective endocarditis ie remains. The clinical presentation depends on the infecting organism and. Definition infection of the endocardial surface of heart characterized by 1colonization or invasion of the heart valves native or prosthetic or by.
These revisions were based on the fact that current data have brought into question the benefit of previous recommendations for infective endocarditis prophylaxis. Streptococcal bacteria causing endocarditis include streptococcus viridans as well as groups a, c, and g streptococcal bacteria. Give three examples of immunologic sequelae of infective endocarditis 4. Theyll give your presentations a professional, memorable appearance the kind of sophisticated look that todays audiences expect. Describe the clinical manifestations of infective endocarditis. Blood cultures remain the standard test for microbial diagnosis, with directed serological testing i. Prosthetic valves 725% of cases of infective endocarditis the rates of infection are the same at 5 years for both mechanical and bioprostheses, but higher for mechanical in first 3 months cumulative risk.
Pathology and pathogenesis of infective endocarditis in. It is often from an infectious source and can cause disorders of the valves and life threatening arrhythmias. Infective endocarditis acute toxic presentation progressive valve. Infective endocarditis also referred to as ie, is an inflammatory disease in which the heart muscle, valves, and the lining of the heart chambers are affected. The aim of this study was to provide a contemporary picture of the presentation, etiology and outcome of infective endocarditis ie in a large. Endocarditis is inflammation of the lining and valves of the heart. Management of infective endocarditis endocardites aquitaine. Formerly known as bacterial endocarditis, endocardial infections are currently named infective endocarditis in order to include both bacterial and fungal microorganisms. Definition infective endocarditis is the inflammation of the endocardium, the inner lining of the heart. It is estimated that about 23 of the cases of endocarditis are caused by streptococcal bacteria. Main complications of leftsided valve infective endocarditis and. Infective endocarditis harrisons principles of internal. A mitral valve vegetation caused by bacterial endocarditis.
Children at highest risk of adverse outcome after infective endocarditis include those with. Classic peripheral manifestations eg, oslers nodes may or may not occur. The prototypic lesion of infective endocarditis, the vegetation, is a mass of platelets, fibrin, microorganisms, and scant inflammatory cells. A free powerpoint ppt presentation displayed as a flash slide show on id. The ability of an organism to cause endocarditis is the result of. Laboratory diagnosis of infective endocarditis journal. Endocarditis is an endovascular microbial infection of intracardiac structures facing the blood, including infections of the large intrathoracic vessels and intracardiac foreign bodies. Moreover, if the valve annulus is affected, the infection will spread into. Janeway lesions nontender haemorrhagic pulps on fingers and toes. Infective endocarditis is the microbial infection of heart valve native or prosthetic the lining of cardiac chamber or blood vessel, or congenital. The clinical presentation of infective endocarditis is highly variable and. Chapter 83 infective endocarditis and valvular disease episode overview. Antibiotic prophylaxis is not recommended for local anaesthetic injections in noninfected tissues, treatment of superficial caries, removal of sutures, dental xrays.
Infective endocarditis current medical diagnosis and treatment. Infective endocarditis arises when an adherent plateletfibrin nidus becomes secondarily infected and produces vegetations, which in turn may directly damage the endocardial tissue andor valves. Epidemiology infective endocarditis is often a complication of congenital or rheumatic heart disease but can also occur in children without any abnormal valves or cardiac malformations. Complications of ie may be apparent from the history, including heart failure. The healthy cardiac endothelium is resistant to frequent bacteraemia caused by daily activities such as. The clinical presentation of infective endocarditis is highly variable and nonspecific, although a fever and murmur are usually present. List 5 common bacteria responsible for infective endocarditis 3. Infective endocarditis is an infection in the heart valves or endocardium. Definition infective endocarditis ie is a microbial infection of the endocardial endothelial surface of the heart. Pathophysiology of infective endocarditis springerlink. It occurs due to bacterial and fungal infection and as serious complication of congenital heart disease and reheumatic valvular heart disease. Infective endocarditis american academy of pediatrics. Although recognized as prognostically important, the pathologic description has often been limited to the. Endocarditis is a bacterial or fungal infection of the valvular or endocardial surface of the heart.
Infective endocarditis symptoms, diagnosis and treatment. Ppt infective endocarditis powerpoint presentation. Endocarditis is defined as an inflammation of the endocardial surface of the heart. Explain issues related to the diagnosis and management of infective endocarditis.
Preventive measures including antimicrobial prophylaxis may reduce the risk of initial and recurrent ie for patients with relevant risk factors. Vegetations may result in valvular incompetence or obstruction. The most recent revision of the american heart association guidelines on infective endocarditis prophylaxis occurred in 2007. Ie disproportionately affects those with underlying. Clinical presentation, etiology and outcome of infective endocarditis. In most cases, the inflammation is related to a bacterial or fungal. Infectious endocarditis results from bacterial or fungal infection of the endocardial surface of the heart and is associ ated with significant morbidity and mortality. Infective endocarditis ie is an infection involving the endocardial surface of the heart, including the valvular structures, the chordae tendineae, sites of septal defects, or the mural endocardium. The bloodcirculating microbes usually need to be available in a certain inoculum to allow invasion and thus infect the heart. Outline native valve endocarditis prosthetic valve endocarditis cardiac implantable device infections unusual causes of endocarditis.
Infective endocarditis role of echo american society of. Introduction the management of infective endocarditis ie includes prompt diagnosis, treatment with antimicrobial therapy, and in some cases of complicated ie, surgical management. Definitions a microbial infection of a cardiac valve or the endocardium caused by bacteria, fungi, or chlamydia often categorized as acute or s ubacute based on the rapidity of the clinical course alternatively described by type of risk factor e. Infective endocarditis an overview sciencedirect topics. Changing epidemiology, advances in blood culture techniques, and new diagnostics guide the application of laboratory testing for diagnosis of endocarditis. This inflammation may lead to valvular insufficiency which can progress to congestive heart failure and myocardial abscesses. The diagnosis of infective endocarditis requires the integration of clinical, laboratory, and echocardiographic findings. Pcr for microbial 16s ribosomal rna genes from valve tissue if culture negative. Infective endocarditis ie is an uncommon infection, occurring as a complication in varying percentages of bacteremic episodes. Subacute bacterial endocarditis is a slowly developing type of infective endocarditis that is lifethreatening. This may include heart valves, mural endocardium or the endocardium that covers implanted material, such as prosthetic valves, pacemakerdefibrillator leads and catheters. Infective endocarditis ie is an evolving disease with a persistently high mortality and morbidity, even in the modern era of advanced diagnostic imaging, improved antimicrobial chemotherapy, and. Definitions a microbial infection of a cardiac valve or the endocardium caused by bacteria, fungi, or chlamydia often categorized as acute or subacute based on the rapidity of the clinical course alternatively described by type of risk factor e. The clinical symptoms of acute ie result from either embolic or intracardiac suppurative complications.
The pathophysiology involves various factors including the cardiac endothelium, hemostatic mechanisms, the immune system, cardiac anatomic abnormalities, and surface properties of microorganisms. Winner of the standing ovation award for best powerpoint templates from presentations magazine. Diagnosis of infective endocarditis using echocardiography. Chapter 83 infective endocarditis and valvular disease. The clinical presentation of subacute ie is variable, but the presentation of. Endocarditis refers to endothelial damage with thrombosis on endocardial surfaces, typically on the heart valves see the image below.