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Bacterial Endocarditis
(CR005)

Introduction


Bacterial endocarditis (BE) is a serious infection of the endocardium or the heart that occurs when certain bacteria in the bloodstream adhere onto abnormal heart valves or other damaged heart tissue. The resulting infection can rapidly and severely damage the heart valves. A common causative bacteria is staphylococcus, but any organism entering the bloodstream from any site of prior infection can lead to the development of BE.

Subacute bacterial endocarditis (SBE) occurs when bacteria lodge on damaged heart valves and produce clusters or vegetations, on the valves. Frequently symptoms of SBE are mild or vague. Pieces of these vegetations may dislodge and travel through the blood as emboli to such areas as the brain, spleen, or kidneys. SBE is usually caused by either streptococcus (other than group A) or enterococcus bacteria.

Management of IE traditionally required a lengthy hospitalization for intravenous antibiotics. The recent trend, however, is to use shorter treatment courses, oral and once-daily regimens and outpatient programs.

Prompt diagnosis, identification of the causative organism, recognition of complications, and timely initiation of effective treatment with the appropriate antibiotic is important to ensuring a good outcome. Another goal is prevention of BE in persons with increased risk due to valve or heart conditions by administering preventive (prophylactic) antibiotics prior to high-risk procedures.

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