title: Infective Endocarditis.
abstract: Infective endocarditis (IE) is a noncontagious infection of the endocardium and heart valves. The epidemiology of IE has shifted recently with an increase in health care-associated IE. Infective endocarditis requiring intensive care unit stay is increasing, and nosocomial IE is frequently responsible. Diagnosis of IE requires multiple clinical data points encompassing history and physical examination, microbiology, and cardiac imaging as no one test is sufficiently sensitive or specific. The modified Duke criteria algorithm is the standard of care in the clinical diagnosis of IE. Complications from IE are common, particularly so in the critical care setting, and include congestive heart failure, embolism, septic shock, invasive infection, prosthetic valve dehiscence, heart block, and mycotic aneurysm. A multidisciplinary care team of infectious disease, cardiology, and cardiac surgery physicians is recommended to reduce complications. Intravenous antibiotics are first-line therapy with cardiac surgery being reserved for certain complications of IE and/or for clinical situations in which there is a high risk of complications. Timing of surgery for IE remains controversial and depends on a variety of clinical factors.
authors.affiliation: Division of Cardiology, Department of Medicine, Duke University Medical Center, Durham, NC, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Klein
authors.affiliation: Division of Cardiology, Department of Medicine, Duke University Medical Center, Durham, NC, USA a.wang@duke.edu.
authors.forename: Andrew
authors.initials: A
authors.lastname: Wang
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D006348:Cardiac Surgical Procedures / Q000379:methods*; D003422:Critical Care; D004452:Echocardiography; D004697:Endocarditis, Bacterial / Q000175:diagnosis* / Q000188:drug therapy; D006801:Humans; D007362:Intensive Care Units; D033183:Interdisciplinary Communication; D017410:Practice Guidelines as Topic; D011379:Prognosis; D018570:Risk Assessment
chemical_list: D000900:Anti-Bacterial Agents
keywords: complications; diagnosis; infective endocarditis; intensive care; treatment