Infective Endocarditis

Infective endocarditisInfective endocarditis (IE) is a microbial infection of the endocardial surface of the heart. While rare in the general population, it occurs at a higher frequency in select patient populations at risk, including childrenChildren with unrepaired, palliated, and repaired congenital heart diseaseCongenital heart disease, particularly those with prosthetic valves and residual lesions. About 90% of cases are caused by Gram positive cocci, including alpha-hemolytic StreptococciStreptococci and Staphylococcus aureusStaphylococcus aureas. The clinical presentation can be sub-acute or severe and may include manifestations directly related to the infective illness, the immunologic response to endocarditisEndocarditis, hemodynamic compromise, or manifestations from pulmonary or systemic embolization. The modified Duke criteriaDuke criteria are used for diagnosis, and involve pathologic, clinical, laboratory, and imaging elements. Early treatment is crucial, and a low index of suspicion considered for any at-risk patient with an unexplained fever or new illness. Treatment should be targeted to the identified organism, with surgical intervention when indicated. Ultimately, the primary goal is the prevention of IE through goodSubacute bacterial endocarditis (SBE) general and oral hygiene and antibiotic prophylaxis when indicated in select circumstances.