Infective endocarditis

Abstract

Infective endocarditis (IE) is a rare, life-threatening disease that has long-lasting effects even among patients who survive and are cured. IE disproportionately affects those with underlying structural heart disease and is increasingly associated with healthcare contact, particularly in patients who have intravascular prosthetic material. In the setting of bacteraemia with a pathogenic organism, an infected vegetation may form as the end result of complex interactions between invading microorganisms and the host immune system. Once established, IE can involve almost any organ system in the body. The diagnosis of IE may be difficult to establish and a strategy that combines clinical, microbiological and echocardiography results has been codified in the modified Duke criteria. In cases of blood culture-negative IE, the diagnosis may be especially challenging and novel microbiological and imaging techniques have been developed to establish its presence. Once diagnosed, IE is best managed by a multidisciplinary team with expertise in infectious diseases, cardiology and cardiac surgery. Antibiotic prophylaxis for the prevention of IE remains controversial. Efforts to develop a vaccine targeting common bacterial causes of IE are ongoing, but have not yet yielded a commercially available product.

Infective endocarditis due to Bartonella bacilliformis associated with systemic vasculitis: a case report

“…Several infections, including IE, cause positive ANCA tests by indirect immunofluorescence but negative ELISA testing. Our patient presented with positive p-ANCA (by ELISA); thus, this finding was most probable because of an AAV 1,11 . Glomerulonephritis is the most frequent histological finding in this type of vasculitis; however, some cases may consist of interstitial nephritis without glomerular involvement, as shown in this patient 12 .…”

“…Additionally, a few Bartonella spp. have been identified as causes of endocarditis, with Bartonella quintana and Bartonella henselae being the most common 1 . Bartonella bacilliformis, the etiologic agent of Carrion's disease (CD), has also been reported as a cause of endocarditis in a pediatric patient with a history of right ventricular-coronary artery fistula 2 .…”

Risk stratification biomarkers for Staphylococcus aureus bacteraemia

“…Previous studies identified several candidate innate immunity biomarkers that were independently associated with mortality and prolonged SAB, supporting the utility of biomarkers to distinguish patients prone to developing severe disease . Such information would be particularly beneficial in guiding diagnostic work‐up of patients at increased risk of S. aureus infective endocarditis (IE), a disease that even with the best available treatments has contemporary in‐hospital mortality rates ranging from 25 to 46% …”

“…1,[4][5][6][7] Such information would be particularly beneficial in guiding diagnostic work-up of patients at increased risk of S. aureus infective endocarditis (IE), a disease that even with the best available treatments has contemporary in-hospital mortality rates ranging from 25 to 46%. [8][9][10] To investigate the contribution of the differential immune response to SAB disease severity, we previously identified biomarker profiles associated with mortality and persistent bacteraemia in a twophase case-control study of patients with complicated SAB. There, we evaluated a panel of 13 candidate biomarkers in patients with complicated SAB enriched for persistent bacteraemia and mortality and observed that high IL-17A, IL-10 and soluble E-selectin (sE-selectin) levels at presentation were prognostic for persistent bacteraemia, while high levels of IL-8 and CCL2 were prognostic for mortality.…”

Surgical Treatment of Valvular Infective Endocarditis Complicated by An Abscess: A Single Center’s Experience

“…In recent years, new microorganisms have been emerging with increasing incidence, especially affecting intracardiac devices [1]. The old term "bacterial endocarditis" has largely been replaced by the more accurate terms "infective" or "infectious" endocarditis, since infections caused by microorganisms other than bacteria are possible and not at all infrequent [2]. The reported incidence of infectious endocarditis in the general population is 3-10 episodes per 100,000 people per year, though IE is less common in the young and especially common in seniors between the ages of 70 and 80 years [3].…”