Overview
Infective endocarditis is microbial infection of the endocardial surface, most commonly involving cardiac valves.
The disease can cause valve destruction, heart failure, embolization, and systemic infection.
Clinical Features
Fever, malaise, weight loss, changing murmur, embolic phenomena, or features of heart failure may occur.
Peripheral manifestations can include splinter hemorrhages, petechiae, or other vascular or immune phenomena.
Investigation
Multiple blood cultures and echocardiography are central to diagnosis.
Blood cultures should ideally be obtained before antibiotics in clinically stable patients when this can be done safely.
Management
Treatment requires prolonged targeted antimicrobial therapy. Surgery may be required for severe valve destruction, heart failure, persistent infection, or selected embolic-risk situations.
Clinical Pearls
Think endocarditis when there is persistent fever + compatible risk + possible valvular findings.
END OF REVIEW
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