This document discusses infective endocarditis, including its definitions, epidemiology, pathogenesis, clinical manifestations, diagnosis, treatment, and prevention. Some key points include: - It involves microbial infection of the heart valves and is usually caused by bacteria like streptococci, staphylococci, and enterococci. - Common symptoms include fever and heart murmur. Potential complications include heart failure, embolisms, and metastatic abscesses. - Diagnosis involves blood cultures, echocardiography, and published clinical criteria. - Treatment involves antibiotics tailored to the infecting organism, with surgery for complications or high-risk cases. - Prevention focuses on antibiotic prophylaxis for high-risk

1. Infective Endocarditis 高雄醫學大學附設醫院 心臟內科

16. Infective Endocarditis Frequency of preexisting cardiac lesion in Patients with IE Age (%) Lesion Under 2 years 2-15 years 15-50 years >50 years IVDU adults No known heart disease 50-70 10-15 10-20 10 50-60 Congenital heart disease 30-50 70-80 25-35 15-25 10 Rheumatic heart disease Rare 10 10-15 10-15 10 Degenerative heart disease 0 0 Rare 10-20 Rare Previous cardiac surgery 5 10-15 10-20 10-20 10-20 Previous endocarditis Rare 5 5-10 5-10 10-20

17. Infective Endocarditis

18. Organisms Causing Infective Endocarditis

19. Infective Endocarditis

20. Infective Endocarditis

21. IE Clinical Manifestations Systemic Manifestation

25. Venturi Effect

32. Janeway Lesions

33. Splinter Hemorrhage

34. Osler’s Nodes

35. Subconjunctival Hemorrhages

36. Roth’s Spots

45. Infective Endocarditis - Principles of Therapy

46. Microbiologic Cure Rate for Endocarditis Virridan streptococci, group A strep 98 98 Enterococcus 90 >90 S. aureus (young IVDU) 90 >90 S. aureus (elderly patients with underlying disease 50 70 Gram negative aerobic bacilli 40 65 Native Valve Endocarditis Antimicrobial therapy alone Antimicrobial therapy plus Surgery Fungus <5 50

47. Microbiologic Cure Rate for Endocarditis Prosthetic valve endocarditis Antimicrobial therapy alone Antimicrobial therapy plus Surgery Early PVE Late PVE Early PVE Late PVE Virridan streptococci, group A strep NA 80 NA 90 Enterococcus NA 60 NA 75 S. aureus 25 40 50 60 Coagulase negative staphylococcus 20 40 60 70 Gram negative aerobic bacilli <10 20 40 50 Fungus <1 <1 30 40

55. This wallet card is to be given to patients by their physician. Healthcare professionals, please see back of card for reference to the complete statement. Name: ____________________________________________ needs protection from BACTERIAL ENDOCARDITIS because of an existing HEART CONDITION Diagnosis: __________________________________________ Prescribed by: _______________________________________ Date: ______________________________________________