Introductory Chapter: Endocarditis - A Diagnostic and Therapeutic Challenge

Abstract

Infective endocarditis IE , relecting infections of the heart as manifested by vegetations on the valvular structures, abscess cavities of the myocardium, invasive istula, or infections on intracardiac prosthetic devices represents a signiicant problem that continues to challenge clinicians. The epidemiology of infections relects not only the dark side of the progresses in medical therapy but also some of the social problems that plague modern society. The changing microbiology also relects how this complex disease has also paralleled the advances in medicine. Diagnostic tools continue to evolve with not only improvements in imaging technologies but also our understandings on how to appropriately use them to beter understand the overall clinical picture. In addition, the role of therapies especially early surgical intervention has been demonstrated to have a signiicant impact on the management and outcomes of infected patients. The goal of this text is to highlight some of the current concepts in the clinical characteristics, presentation, diagnosis, and management options.

Genome-Based Drug Target Identification in Human Pathogen Streptococcus gallolyticus

“…Among 100,000 population, 2.6–7 cases of endocarditis have been reported per year, a significant proportion of which was contributed by streptococcal infections: with incidence of 17% in North America, 31% in other European countries, 39% in the South America, and 32% in rest of the world ( Holland et al, 2016 ). This disease mostly occurs in elderly patients ( Firstenberg, 2016 ), and the median age of patients is ≥58 ( Vilcant and Hai, 2018 ). The risk of developing Sg endocarditis rises with the consumption of uncooked meat or fresh dairy products, weakened immune system, history of hepatic diseases, and comorbidities such as diabetes mellitus and rheumatic disorders ( Cãruntu et al, 2014 ).…”

Integration of molecular docking and molecular dynamics simulations with subtractive proteomics approach to identify the novel drug targets and their inhibitors in Streptococcus gallolyticus

“…By excluding any proteins with human homologs, subtractive proteomics significantly reduces the risk of cross-reactivity and potential side effects, thereby improving the safety profile of the drugs produced. This strategic method directs drug development efforts toward bacterial-specific proteins, resulting in greater specificity and efficacy in treating bacterial infections 4 – 6 . Therapeutic target identification is a critical step in computer-based drug design methods 36 .…”

“…The 2.6–7 cases of endocarditis per 100,000 individuals reported annually were primarily caused by streptococcal infections; incidences were 39% in South America, 31% in other European countries, 17% in North America, and 32% worldwide 5 . With a median age of 58, the disease primarily affects older adults 6 . Sg endocarditis is more common in people who eat dairy products, have a history of hepatic disease, and have conditions like diabetes mellitus and rheumatoid arthritis 7 .…”

Introductory Chapter: Endocarditis

“…A common theme in many of these chapters is the decision-making process and role for surgery. A point that requires further emphasis is the role for early surgery and how this concept needs to cage every aspect of a larger treatment plan, specifically [19]:…”