Endocarditis

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Endocarditis
infectious disease

Endocarditis is an

subacute form of infective endocarditis, a vegetation may also include a center of granulomatous tissue, which may fibrose or calcify.[2]

There are several ways to classify endocarditis. The simplest classification is based on cause: either infective or non-infective, depending on whether a

echocardiogram, and blood cultures
demonstrating the presence of endocarditis-causing microorganisms.

Signs and symptoms include fever, chills, sweating, malaise, weakness, anorexia, weight loss, splenomegaly, flu-like feeling, cardiac murmur, heart failure, petechia (red spots on the skin), Osler's nodes (subcutaneous nodules found on hands and feet), Janeway lesions (nodular lesions on palms and soles), and Roth's spots (retinal hemorrhages).

Infective endocarditis

Main article: Infective endocarditis

Infective endocarditis is an

valvular insufficiency, heart failure, stroke, and kidney failure.[4][3]

The cause is typically a

staphylococci.[3]

The diagnosis of infective endocarditis relies on the

Duke criteria, which were originally described in 1994 and modified in 2000. Clinical features and microbiological examinations are the first steps to diagnose an infective endocarditis. The imaging is also crucial. Echocardiography is the cornerstone of imaging modality in the diagnosis of infective endocarditis. Alternative imaging modalities as computer tomography, magnetic resonance imaging, and positron emission tomography/computer tomography (PET/CT) with 2-[18F]fluorodeoxyglucose (FDG) are playing an increasing role in the diagnosis and management of infective endocarditis.[6]

The usefulness of

heart surgery is required.[3][8] Populations at high risk of infective endocarditis include patients with previous infective endocarditis, patients with surgical or transcatheter prosthetic valves or post-cardiac valve repair, and patients with untreated CHD and surgically corrected congenital heart disease.[9][10]

The number of people affected is about 5 per 100,000 per year.[5] Rates, however, vary between regions of the world.[5] Males are affected more often than females.[3] The risk of death among those infected is about 25%.[5] Without treatment it is almost universally fatal.[3]

Non-infective endocarditis

Main article:
Noninfective endocarditis

Trousseau syndrome can be encountered. Typically NBTE does not cause many problems on its own, but parts of the vegetations may break off and embolize to the heart or brain, or they may serve as a focus where bacteria can lodge, thus causing infective endocarditis.[2]

Another form of sterile endocarditis is termed Libman–Sacks endocarditis; this form occurs more often in patients with lupus erythematosus and is thought to be due to the deposition of immune complexes.[2] Like NBTE, Libman-Sacks endocarditis involves small vegetations, while infective endocarditis is composed of large vegetations.[2] These immune complexes precipitate an inflammation reaction, which helps to differentiate it from NBTE. Also unlike NBTE, Libman-Sacks endocarditis does not seem to have a preferred location of deposition and may form on the undersurfaces of the valves or even on the endocardium.[2]

References

  1. OCLC 54501403
    .
  2. ^
    ISBN 978-1-4160-2973-1
    .
  3. ^ a b c d e f g h i j k "Infective Endocarditis - Cardiovascular Disorders". Merck Manuals Professional Edition. September 2017. Retrieved 11 December 2017.
  4. PMID 27886786
    .
  5. ^
    S2CID 24935834
    .
  6. S2CID 215803991
    .
  7. S2CID 25918810
    .
  8. PMID 37622656
    .
  9. PMID 37622656
    .
  10. PMID 36946284
    .

Further reading
Scholia has a topic profile for Endocarditis.
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