PT  - JOURNAL ARTICLE
AU  - Keys, Thomas F.
TI  - Diagnosis and management of infective endocarditis
DP  - 1990 Sep 01
TA  - Cleveland Clinic Journal of Medicine
PG  - 558--562
VI  - 57
IP  - 6
4099  - http://www.ccjm.org/content/57/6/558.short
4100  - http://www.ccjm.org/content/57/6/558.full
SO  - Cleve Clin J Med1990 Sep 01; 57
AB  - Advances in chemotherapy and surgery have significantly improved the outcome of infective endocarditis, but the disease remains a therapeutic challenge with an overall mortality of 20%. More cases of infective endocarditis seen today are associated with prosthetic heart valves, intravenous drug abuse, or complications of medical and surgical technology. Prosthetic valve endocarditis occurs in 1% to 4% of patients with prosthetic valves. Echocardiography is not a precise diagnostic test for endocarditis, but it helps detect a variety of cardiac lesions, including valvular incompetence, annular ring abscesses, and sometimes vegetations. Serum bactericidal titers are predictive of neither cure nor treatment failure. The principal indication for urgent surgical intervention is acute valvular dysfunction. Other considerations for surgery include evidence of myocardial invasion, infection by antibiotic-resistant organisms, and large vegetations. For patients at risk of infective endocarditis, antibiotic prophylaxis during invasive procedures is an accepted practice.