title: 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 health care 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 that targets common bacterial causes of IE are ongoing, but have not yet yielded a commercially available product.
authors: Department of Medicine, Division of Infectious Diseases, Duke University Medical Center, Room 185 Hanes Building, 315 Trent Drive, Durham, North Carolina 27710, USA.|Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina, USA.
authors: Thomas L
authors: TL
authors: Holland
authors: Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA.
authors: Larry M
authors: LM
authors: Baddour
authors: Department of Medicine, David Geffen School of Medicine at UCLA, Torrance, California, USA.
authors: Arnold S
authors: AS
authors: Bayer
authors: Department of Infectious Diseases, University Hospital of Pointe-Pitre, Pointe-Pitre, France.
authors: Bruno
authors: B
authors: Hoen
authors: Infectious Diseases Service, Hospital Clinic - IDIBAPS, University of Barcelona, Barcelona, Spain.
authors: Jose M
authors: JM
authors: Miro
authors: Department of Medicine, Division of Infectious Diseases, Duke University Medical Center, Room 185 Hanes Building, 315 Trent Drive, Durham, North Carolina 27710, USA.|Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina, USA.
authors: Vance G
authors: VG
authors: Fowler
mesh_terms: D016470:Bacteremia / Q000188:drug therapy / Q000209:etiology; D004452:Echocardiography / Q000379:methods; D004696:Endocarditis / Q000175:diagnosis* / Q000503:physiopathology* / Q000628:therapy*; D006351:Heart Valves / Q000382:microbiology / Q000503:physiopathology; D006801:Humans; D007238:Infarction / Q000150:complications / Q000209:etiology