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Endocarditis, Infective

Theodore B. Flaum, DO and Ian Paul Persits, D.O., M.S. Reviewed 06/2022
 


BASICS

Infective endocarditis (IE) is an infection of the inner layer of the heart including the valves (native/prosthetic), interventricular septum, intracardiac devices, chordae tendineae, and mural...

DIAGNOSIS

  • Modified Duke Criteria (1)[B] (definite: 2 major criteria, or 1 major and 3 minor criteria, or 5 minor criteria; possible: 1 major and 1 minor or 3 minor criteria)

  • Major clinical criteria

    • Pos...

TREATMENT

MEDICATION

First Line

  • Start empiric treatment after three sets of blood cultures have been drawn. Results guide treatment.

    • Native valves: ampicillin-sulbactam IV with gentamicin IV/IM. If penic...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Baseline ECG; monitor ECG for conduction disturbances/MI in initial weeks of therapy.

  • TTE at the conclusion of therapy

  • Blood cultures q48h until n...

REFERENCES

1
Baddour  LM, Wilson  WR, Bayer  AS, et al; for American Heart Association Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease of the Council on Cardiova...

CODES

ICD10

  • I33.0 Acute and subacute infective endocarditis

  • I39 Endocarditis and heart valve disord in dis classd elswhr

  • A54.83 Gonococcal heart infection

  • B37.6 Candidal endocarditis

SNOMED

  • 233850007 infect...

CLINICAL PEARLS

  • Preprocedural antibiotic prophylaxis is recommended for patients with artificial heart valves, a previous history of IE, CHD, and cardiac transplants with valvulopathy.

  • TEE/TTE and bloo...

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