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Infective endocarditis is a complex and potentially life-threatening infection that affects the heart’s endocardium and valves. Early diagnosis and prompt treatment are essential for reducing morbidity and mortality associated with this condition. Prevention measures, careful patient evaluation, and antibiotic prophylaxis in select cases remain crucial in managing IE, particularly in individuals with underlying cardiac conditions or other risk factors. Understanding the epidemiology, etiology, and pathophysiology of IE is critical for healthcare professionals to provide optimal care for affected patients.
Infective endocarditis occurs at an estimated incidence of 3-10 cases per 100,000 person-years, with variations based on risk factors and geographic regions. It predominantly affects adults, particularly those with underlying heart conditions, intravenous drug users, and elderly individuals.
It can result from various pathogens, predominantly bacteria. Streptococci and staphylococci species are common, with Staphylococcus aureus being particularly virulent. Other pathogens, including fungi and less frequently, viruses, can also cause IE.
Endocarditis typically begins with endothelial damage, providing a substrate for microbial adherence. Pathogens enter the bloodstream, often through dental procedures, skin infections, or intravenous drug use, and colonize damaged heart valves. This leads to the formation of microbial vegetations, which can embolize to other organs, causing systemic complications.
Diagnosis relies on clinical criteria, including the modified Duke criteria, which incorporate clinical, microbiological, and echocardiographic findings. Blood cultures are essential for identifying the causative microorganism. Transthoracic and transesophageal echocardiography help visualize vegetations, valvular abnormalities, and assess the extent of involvement.
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