Infectious endocarditis: An update for emergency clinicians

The American Journal of Emergency Medicine
Brit Long, Alex Koyfman

Abstract

Infectious endocarditis (IE) is a potentially deadly disease without therapy and can cause a wide number of findings and symptoms, often resembling a flu-like illness, which makes diagnosis difficult. This narrative review evaluates the presentation, evaluation, and management of infective endocarditis in the emergency department, based on the most current literature. IE is due to infection of the endocardial surface, most commonly cardiac valves. Major risk factors include prior endocarditis (the most common risk factor), structural heart damage, IV drug use (IVDU), poor immune function (vasculitis, HIV, diabetes, malignancy), nosocomial (surgical hardware placement, poor surgical technique, hematoma development), and poor oral hygiene, and a wide variety of organisms can cause IE. Patients typically present with flu-like illness. Though fever and murmur occur in the majority of cases, they may not be present at the time of initial presentation. Other findings such as Roth spots, Janeway lesions, Osler nodes, etc. are not common. An important component is consideration of risk factors. A patient with IVDU (past or current use) and fever should trigger consideration of IE. Other keys are multiple sites of infection, poor dentit...Continue Reading

References

Aug 1, 1991·Journal of the American College of Cardiology·B K ShivelyN B Schiller
Mar 21, 1991·The New England Journal of Medicine·W G DanielP R Lichtlen
Nov 1, 1995·The American Journal of Cardiology·J A BerlinD Kaye
Mar 1, 1995·European Heart Journal·F DelahayeC Leport
Sep 1, 1993·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·A S Bayer
Jan 1, 1997·Annual Review of Medicine·M DasW R Wilson
Apr 19, 2000·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·J S LiG R Corey
May 18, 2000·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·S De CastroN G Pandian
Aug 2, 2001·American Heart Journal·T J MeineA Wang
Feb 16, 2002·The Journal of Hospital Infection·H Giamarellou
May 2, 2002·Critical Care : the Official Journal of the Critical Care Forum·Georg KarthPeter Siostrzonek
Jan 7, 2003·Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography·Harmony R ReynoldsItzhak Kronzon
Apr 13, 2004·Current Opinion in Cardiology·Roni K DevlinC Fordham von Reyn
May 18, 2004·Heart·A Evangelista, M T Gonzalez-Alujas
Jul 1, 2004·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·F R CockerillW R Wilson
Jun 24, 2005·JAMA : the Journal of the American Medical Association·Imad M TleyjehLarry M Baddour
Jul 20, 2005·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·José M MiroUNKNOWN International Collaboration on Endocarditis Merged Database Study Group
Nov 18, 2005·American Heart Journal·Andrew WangUNKNOWN International Collaboration on Endocarditis Investigators
Nov 18, 2005·American Heart Journal·Christopher H CabellUNKNOWN International Collaboration on Endocarditis Merged Database (ICE-MD) Study Group Investigators
Dec 21, 2005·Heart·Gilbert Habib
Jul 11, 2006·Current Infectious Disease Reports·Eleonora WidmerPhilippe Moreillon
Aug 18, 2006·The New England Journal of Medicine·Vance G FowlerUNKNOWN S. aureus Endocarditis and Bacteremia Study Group
Mar 30, 2007·JAMA : the Journal of the American Medical Association·Andrew WangUNKNOWN International Collaboration on Endocarditis-Prospective Cohort Study Investigators
Sep 21, 2007·Journal of Clinical Microbiology·Andrew LeeMelvin P Weinstein
Oct 25, 2007·The Australasian Journal of Dermatology·Todd H Gunson, G Fergus Oliver
Dec 18, 2007·The American Journal of Cardiology·Mark E Silverman, Charles B Upshaw
Dec 25, 2007·Progress in Cardiovascular Diseases·Gilbert HabibJean-François Avierinos
Jan 4, 2008·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Vivian H ChuUNKNOWN International Collaboration on Endocarditis-Prospective Cohort Study Group
Feb 12, 2008·The American Journal of Medicine·Thomas J Marrie
Feb 29, 2008·Journal of Clinical Microbiology·Stefan RiedelGary V Doern
Oct 29, 2008·Archives of Internal Medicine·Emanuele Durante-MangoniUNKNOWN International Collaboration on Endocarditis Prospective Cohort Study Group
Mar 11, 2009·Archives of Internal Medicine·David R MurdochUNKNOWN International Collaboration on Endocarditis-Prospective Cohort Study (ICE-PCS) Investigators
Mar 10, 2010·Circulation·Bernard D Prendergast, Pilar Tornos

❮ Previous
Next ❯

Citations

Feb 8, 2020·Antibiotics·Lene K VestbyLive L Nesse
May 15, 2020·The Cochrane Database of Systematic Reviews·Arturo J Martí-CarvajalCristina Elena Martí-Amarista
Sep 4, 2019·Journal of the American Academy of Dermatology·Corey GeorgesenJoanna Harp
Feb 8, 2021·Applied Nursing Research : ANR·Jennifer P ColwillLee Anne Siegmund
Oct 23, 2019·The Journal of Emergency Medicine·Brit Long, Alex Koyfman
Nov 5, 2021·Journal of Epidemiology and Global Health·Mazin BarryYahya Al Hebaishi

❮ Previous
Next ❯

Related Concepts

Related Feeds

Addiction

This feed focuses mechanisms underlying addiction and addictive behaviour including heroin and opium dependence, alcohol intoxication, gambling, and tobacco addiction.

HIV/AIDS-Related Malignancies

HIV/AIDS infection increases the risk of non-communicable diseases common in the aged including HIV/AIDS-related malignancies. Discover the latest research in HIV/AIDS-related malignancies.