- Section 1 ICU organization and management
- Section 2 Pharmacotherapeutics
- Section 3 Resuscitation
- Section 4 The respiratory system
- Section 5 The cardiovascular system
- Part 5.1 Physiology
- Part 5.2 Cardiovascular monitoring
- Part 5.3 Acute chest pain and coronary syndromes
- Part 5.4 Aortic dissection
- Part 5.5 The hypotensive patient
- Part 5.6 Cardiac failure
- Part 5.7 Tachyarrhythmias
- Part 5.8 Bradyarrhythmias
- Part 5.9 Valvular problems
- Part 5.10 Endocarditis
- Chapter 160 Pathophysiology and causes of endocarditis
- Chapter 161 Prevention and treatment of endocarditis
- Part 5.11 Severe hypertension
- Part 5.12 Severe capillary leak
- Part 5.13 Pericardial tamponade
- Part 5.14 Pulmonary hypertension
- Part 5.15 Pulmonary embolus
- Section 6 The gastrointestinal system
- Section 7 Nutrition
- Section 8 The renal system
- Section 9 The neurological system
- Section 10 The metabolic and endocrine systems
- Section 11 The haematological system
- Section 12 The skin and connective tissue
- Section 13 Infection
- Section 14 Inflammation
- Section 15 Poisoning
- Section 16 Trauma
- Section 17 Physical disorders
- Section 18 Pain and sedation
- Section 19 General surgical and obstetric intensive care
- Section 20 Specialized intensive care
- Section 21 Recovery from critical illness
- Section 22 End-of-life care
(p. 743) Endocarditis
Endocarditis is defined as an inflammation of the endocardial surface of the heart. This may include heart valves, mural endocardium or the endocardium that covers implanted material, such as prosthetic valves, pacemaker/defibrillator leads and catheters. Infective and non-infective-related causes must be distinguished. In most cases, the inflammation is related to a bacterial or fungal infection with oral streptococci, group D streptococci, staphylococci and enterococci accounting for 85% of episodes. Infective endocarditis (IE) is a serious disease with an incidence ranging from 30 to 100 episodes/million patient-years. From various portals of entry (e.g. oral, digestive, cutaneous) and a subsequent bacteraemia, pathogens can adhere and colonize intracardiac foreign material or onto previously damaged endocardium due to numerous complex processes based on a unique host–pathogen interaction. Rarely, endocarditis can be related to non-infective causes, such as immunological or neoplastic. Mortality is high, with more than one-third dying within a year of diagnosis from complications such as acute heart failure or emboli. This disease still remains a diagnostic challenge with many cases being identified and subsequently treated too late. Diagnosis of IE usually relies on the association between an infectious syndrome and recent endocardial involvement. Blood cultures and echocardiography are the main diagnostic procedures, but are negative in almost 30% of cases, requiring the use of more sophisticated techniques. Computed tomography, magnetic resonance imaging and positron emission tomography are promising imaging modalities. Improved understanding of its pathophysiology and the development of relevant diagnostic strategies enables accelerated identification and treatment, and thus an improved prognosis.
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- Section 1 ICU organization and management
- Section 2 Pharmacotherapeutics
- Section 3 Resuscitation
- Section 4 The respiratory system
- Section 5 The cardiovascular system
- Part 5.1 Physiology
- Part 5.2 Cardiovascular monitoring
- Part 5.3 Acute chest pain and coronary syndromes
- Part 5.4 Aortic dissection
- Part 5.5 The hypotensive patient
- Part 5.6 Cardiac failure
- Part 5.7 Tachyarrhythmias
- Part 5.8 Bradyarrhythmias
- Part 5.9 Valvular problems
- Part 5.10 Endocarditis
- Chapter 160 Pathophysiology and causes of endocarditis
- Chapter 161 Prevention and treatment of endocarditis
- Part 5.11 Severe hypertension
- Part 5.12 Severe capillary leak
- Part 5.13 Pericardial tamponade
- Part 5.14 Pulmonary hypertension
- Part 5.15 Pulmonary embolus
- Section 6 The gastrointestinal system
- Section 7 Nutrition
- Section 8 The renal system
- Section 9 The neurological system
- Section 10 The metabolic and endocrine systems
- Section 11 The haematological system
- Section 12 The skin and connective tissue
- Section 13 Infection
- Section 14 Inflammation
- Section 15 Poisoning
- Section 16 Trauma
- Section 17 Physical disorders
- Section 18 Pain and sedation
- Section 19 General surgical and obstetric intensive care
- Section 20 Specialized intensive care
- Section 21 Recovery from critical illness
- Section 22 End-of-life care