Show Summary Details
Page of

Endocarditis 

Endocarditis
Chapter:
Endocarditis
Author(s):

Dr James Harrison

and Dr Bernard Prendergast

DOI:
10.1093/med/9780199594764.003.0020
Page of

PRINTED FROM OXFORD MEDICINE ONLINE (www.oxfordmedicine.com). © Oxford University Press, 2016. All Rights Reserved. Under the terms of the licence agreement, an individual user may print out a PDF of a single chapter of a title in Oxford Medicine Online for personal use (for details see Privacy Policy and Legal Notice).

date: 21 August 2019

Since the original description of endocarditis by William Osler in 1885 and its association with bacteraemia by Emanuel Libman in 1906, the epidemiology of this elusive condition has changed significantly. Despite significant advances in diagnosis and treatment, infective endocarditis remains a dangerous disease, particularly for people at risk because of a prosthetic valve, congenital heart disease, or a history of infective endocarditis, in whom morbidity and mortality approach 50%.

Recent decades have seen Staphylococcus aureus, often acquired as a result of nosocomial infection or intravenous drug abuse, overtake oral streptococci as the most common pathogen in infective endocarditis in developed nations. Infective endocarditis is also increasingly frequent in the elderly and in those with no previous documentation of valvular heart disease.

With these changes in mind, over the past few years international bodies of authority have significantly revised guidelines for the prevention, diagnosis, and treatment of infective endocarditis. Perhaps the most dramatic change is the reduction in antibiotic prophylaxis before dental and other invasive procedures. These guidelines also emphasize the important role of echocardiography in making an early diagnosis of infective endocarditis and that surgery should be performed earlier than previously recommended.

Unlike some other areas of cardiovascular medicine, the literature on endocarditis is not awash with large multi-centre, randomized, controlled trials, which reflects the challenging nature and heterogeneity of the condition. This chapter includes some of the most important clinical publications concerning the epidemiology, diagnosis, complications, and treatment of infective endocarditis and its possible prevention using antibiotic prophylaxis.

Access to the complete content on Oxford Medicine Online requires a subscription or purchase. Public users are able to search the site and view the abstracts for each book and chapter without a subscription.

Please subscribe or login to access full text content.

If you have purchased a print title that contains an access token, please see the token for information about how to register your code.

For questions on access or troubleshooting, please check our FAQs, and if you can't find the answer there, please contact us.