Infective Endocarditis Diagnosis and Management

ABSTRACT

Background: Infective endocarditis (IE) is a microbial (usually bacteria) infection affecting the heart tissue orthe adjacent vascular endothelium. The blood-circulating microbes usually need to be available in a certaininoculum to allow invasion and thus infect the heart. Moreover, if the valve annulus is affected, the infection willspread into the extravascular areas. The main causative agents in IE are bacteria; however, other causes such asfungi 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 aggressiveone. 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 wasused for articles selection. Conclusion: Diagnosing of infective endocarditis remains the pivotal step inmanagement of these patients; thus, it had been studied widely for many years. Duke or modified Duke Criteriaremain the most famous tool in diagnostic assessment, and they incorporate information from multiple sourcesinto minor and major criteria which will reflect the probability of the disease in the suspected patients. Themainstay treatment of infective endocarditis is intravenous antibiotics, titred to serum levels, and the choicedepends on the suspected causative organism and the valve involved in IE being native or prosthetic. Infectiveendocarditis prophylaxis is still a major point of difference among clinicians. Some institutions advocate forantibiotic prophylaxis in patients undergoing any dental procedure; while, others advised against prophylacticantibiotic.