Endocarditis is an inflammation of the inner lining of the heart chambers and heart valves. It can be acute, with a fulminating infection, or subacute with a more indolent infection. It is less prevalent and more common in older males, especially those with underlying conditions. Symptoms can include fever, heart murmur, splinter hemorrhages, Janeway lesions, Osler's nodes, petechiae, finger clubbing, and Roth's spots. Diagnosis involves blood tests, imaging, and blood cultures. Treatment involves high-dose parenteral antibiotics for an extended period, often 4-6 weeks, sometimes along with surgery. The Duke Criteria provides a standard set of guidelines for diagnosing

1. Endocarditis
Dhaval Joshi

3. Introduction
• Endocarditis is an inflammation of the
endocardium, the membrane lining the
chambers of the heart and covering the cusps
of the heart valves
• Also known as Infective Endocarditis

4. Epidemiology
• Less prevalent
• Found majorly in older adult
• More incidence in male population
• Common with some underlying disease
condition

5. Major types
• Acute – Fulminating infection
• Subacute - indolent infection

8. Pathogenesis

10. CP
• Fever
• Heart murmur

11. Other clinical manifestation
✓ Splinter hemorrhages
✓ Janeway lesions
✓Osler’s nodes
✓ Petechiae
✓ Clubbing of the fingers
✓ Roth’s spots
✓ Emboli

14. Duke Criteria
• Major Criteria:
+Blood culture – common endocarditis
organism
+ ECG or onset of new murmur

15. Duke Criteria
• Minor Criteria:
Presence of predisposing condition
Fever
Embolic disease
Immunologic phenomenon
+ Blood culture with rare organism

16. Duke Criteria - Interpretation
2 major criteria
OR
1 major + 3 minor criteria
OR
5 minor criteria

17. Diagnosis
• CBC
• ESR and CRP elevation
• Blood culture
• ECG
• CT scan & MRI
• RFT

18. Treatment stratergies
• High-dose
• Parenteral route
• Bactericidal antibiotics
• Extended period

19. Basic treatment options
• 4-6 weeks of antibiotics
• Vancomycin or Gentamicin + Ceftriaxone or
Aqueous crystalline penicillin sodium
• Surgery

21. MCQ-1
• A 48 yrs old man presents to the emergency
department with a fever and murmur. This has
been occurring for the past 2 to 3 weeks. The
physical examination is significant for the
image seen below:

22. THANK U !!