eMedicine Specialties > Emergency Medicine > Infectious Diseases

Endocarditis: Multimedia

Author: Keith A Marill, MD, Faculty, Department of Emergency Medicine, Massachusetts General Hospital
Contributor Information and Disclosures

Updated: Nov 23, 2009

Multimedia

A young adult with a history of intravenous drug ...
(Enlarge Image)
Media file 1: A young adult with a history of intravenous drug use diagnosed with right-sided staphylococcal endocarditis and multiple embolic pyogenic abscesses on chest radiograph.
[ CLOSE WINDOW ]
A young adult with a history of intravenous drug ...

A young adult with a history of intravenous drug use diagnosed with right-sided staphylococcal endocarditis and multiple embolic pyogenic abscesses on chest radiograph.

A middle-aged man with a history of intravenous d...
(Enlarge Image)
Media file 2: A middle-aged man with a history of intravenous drug use who presented with severe myalgias and a petechial rash. He was diagnosed with right-sided staphylococcal endocarditis.
[ CLOSE WINDOW ]
A middle-aged man with a history of intravenous d...

A middle-aged man with a history of intravenous drug use who presented with severe myalgias and a petechial rash. He was diagnosed with right-sided staphylococcal endocarditis.

This is a magnified portion of a parasternal long...
(Enlarge Image)
Media file 3: This is a magnified portion of a parasternal long axis view from a transthoracic echocardiogram. There is a small curvilinear vegetation on the mitral valve as indicated. The patient presented with a headache and fever, and CT scan of the brain revealed an occipital hemorrhage. The patient had a history of intravenous drug use and multiple blood cultures grew Staphylococcus aureus.
[ CLOSE WINDOW ]
This is a magnified portion of a parasternal long...

This is a magnified portion of a parasternal long axis view from a transthoracic echocardiogram. There is a small curvilinear vegetation on the mitral valve as indicated. The patient presented with a headache and fever, and CT scan of the brain revealed an occipital hemorrhage. The patient had a history of intravenous drug use and multiple blood cultures grew Staphylococcus aureus.

A young adult with a history of intravenous drug ...
(Enlarge Image)
Media file 4: A young adult with a history of intravenous drug use, endocarditis involving the tricuspid valve with Staphylococcus aureus, and multiple septic pulmonary emboli. Pulmonary lesions on chest radiograph are most prominent in the right upper lobe with both solid and cavitary appearance.
[ CLOSE WINDOW ]
A young adult with a history of intravenous drug ...

A young adult with a history of intravenous drug use, endocarditis involving the tricuspid valve with Staphylococcus aureus, and multiple septic pulmonary emboli. Pulmonary lesions on chest radiograph are most prominent in the right upper lobe with both solid and cavitary appearance.

Adult with methicillin-sensitive native valve <EM...
(Enlarge Image)
Media file 5: Adult with methicillin-sensitive native valve Staphylococcus aureus endocarditis with bacteremia and multiple microabscesses. The reason for greater rash involvement of the left upper extremity as opposed to right was unknown.
[ CLOSE WINDOW ]
Adult with methicillin-sensitive native valve <EM...

Adult with methicillin-sensitive native valve Staphylococcus aureus endocarditis with bacteremia and multiple microabscesses. The reason for greater rash involvement of the left upper extremity as opposed to right was unknown.

More on Endocarditis

Overview: Endocarditis
Differential Diagnoses & Workup: Endocarditis
Treatment & Medication: Endocarditis
Follow-up: Endocarditis
Multimedia: Endocarditis
References
Further Reading
[ CLOSE WINDOW ]

References

  1. Wang A, Athan E, Pappas PA, Fowler VG Jr, Olaison L, Pare C, et al. Contemporary clinical profile and outcome of prosthetic valve endocarditis. JAMA. Mar 28 2007;297(12):1354-61. [Medline].

  2. Durante-Mangoni E, Bradley S, Selton-Suty C, Tripodi MF, Barsic B, Bouza E, et al. Current features of infective endocarditis in elderly patients: results of the International Collaboration on Endocarditis Prospective Cohort Study. Arch Intern Med. Oct 27 2008;168(19):2095-103. [Medline].

  3. Chu VH, Cabell CH, Benjamin DK Jr, Kuniholm EF, Fowler VG Jr, Engemann J, et al. Early predictors of in-hospital death in infective endocarditis. Circulation. Apr 13 2004;109(14):1745-9. [Medline].

  4. Murdoch DR, Corey GR, Hoen B, Miro JM, Fowler VG Jr, Bayer AS, et al. Clinical presentation, etiology, and outcome of infective endocarditis in the 21st century: the International Collaboration on Endocarditis-Prospective Cohort Study. Arch Intern Med. Mar 9 2009;169(5):463-73. [Medline].

  5. Mendiratta P, Tilford JM, Prodhan P, Cleves MA, Wei JY. Trends in hospital discharge disposition for elderly patients with infective endocarditis: 1993 to 2003. J Am Geriatr Soc. May 2009;57(5):877-81. [Medline].

  6. Epaulard O, Roch N, Potton L, Pavese P, Brion JP, Stahl JP. Infective endocarditis-related stroke: Diagnostic delay and prognostic factors. Scand J Infect Dis. May 15 2009;1-5. [Medline].

  7. Chu VH, Miro JM, Hoen B, Cabell CH, Pappas PA, Jones P, et al. Coagulase-negative staphylococcal prosthetic valve endocarditis--a contemporary update based on the International Collaboration on Endocarditis: prospective cohort study. Heart. Apr 2009;95(7):570-6. [Medline].

  8. Reyes MP, Ali A, Mendes RE, Biedenbach DJ. Resurgence of Pseudomonas endocarditis in Detroit, 2006-2008. Medicine (Baltimore). Sep 2009;88(5):294-301. [Medline].

  9. Baddley JW, Benjamin DK Jr, Patel M, Miro J, Athan E, Barsic B, et al. Candida infective endocarditis. Eur J Clin Microbiol Infect Dis. Jul 2008;27(7):519-29. [Medline].

  10. Durack DT, Lukes AS, Bright DK. New criteria for diagnosis of infective endocarditis: utilization of specific echocardiographic findings. Duke Endocarditis Service. Am J Med. Mar 1994;96(3):200-9. [Medline].

  11. Casella F, Rana B, Casazza G, Bhan A, Kapetanakis S, Omigie J, et al. The Potential Impact of Contemporary Transthoracic Echocardiography on the Management of Patients with Native Valve Endocarditis: A Comparison with Transesophageal Echocardiography. Echocardiography. May 26 2009;[Medline].

  12. Choussat R, Thomas D, Isnard R, Michel PL, Iung B, Hanania G, et al. Perivalvular abscesses associated with endocarditis; clinical features and prognostic factors of overall survival in a series of 233 cases. Perivalvular Abscesses French Multicentre Study. Eur Heart J. Feb 1999;20(3):232-41. [Medline].

  13. Feuchtner GM, Stolzmann P, Dichtl W, Schertler T, Bonatti J, Scheffel H, et al. Multislice computed tomography in infective endocarditis: comparison with transesophageal echocardiography and intraoperative findings. J Am Coll Cardiol. Feb 3 2009;53(5):436-44. [Medline].

  14. Fowler VG Jr, Boucher HW, Corey GR, Abrutyn E, Karchmer AW, Rupp ME, et al. Daptomycin versus standard therapy for bacteremia and endocarditis caused by Staphylococcus aureus. N Engl J Med. Aug 17 2006;355(7):653-65. [Medline].

  15. Mekontso Dessap A, Zahar JR, Voiriot G, Ali F, Aissa N, Kirsch M, et al. Influence of preoperative antibiotherapy on valve culture results and outcome of endocarditis requiring surgery. J Infect. May 5 2009;[Medline].

  16. [Guideline] Wilson W, Taubert KA, Gewitz M, Lockhart PB, Baddour LM, Levison M, et al. Prevention of infective endocarditis: guidelines from the American Heart Association: a guideline from the American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee, Council on Cardiovascular Disease in the Young, and the Council on Clinical Cardiology, Council on Cardiovascular Surgery and Anesthesia, and the Quality of Care and Outcomes Research Interdisciplinary Working Group. Circulation. Oct 9 2007;116(15):1736-54. [Medline].

  17. Wang CC, Lee CH, Chan CY, Chen HW. Splenic infarction and abscess complicating infective endocarditis. Am J Emerg Med. Oct 2009;27(8):1021.e3-5. [Medline].

  18. Bach DS. Perspectives on the American College of Cardiology/American Heart Association guidelines for the prevention of infective endocarditis. J Am Coll Cardiol. May 19 2009;53(20):1852-4. [Medline].

  19. Baddour LM, Wilson WR. Infections of prosthetic valves and other cardiovascular devices. In: Principles and Practice of Infectious Diseases. 6th ed. Elsevier Churchill Livingstone; 2005:1022-1044.

  20. Baddour LM, Wilson WR, Bayer AS. Infective endocarditis: diagnosis, antimicrobial therapy, and management of complications - executive summary. Circulation. 2005;111:3167-3184.

  21. [Guideline] Baddour LM, Wilson WR, Bayer AS, Fowler VG Jr, Bolger AF, Levison ME. Infective endocarditis: diagnosis, antimicrobial therapy, and management of complications: a statement for healthcare professionals from the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young, and the Councils on Clinical Cardiology, Stroke, and Cardiovascular Surgery and Anesthesia, American Heart Association: endorsed by the Infectious Diseases Society of America. Circulation. Jun 14 2005;111(23):e394-434. [Medline].

  22. Bayer AS, Bolger AF, Taubert KA. Diagnosis and management of infective endocarditis and its complications. Circulation. Dec 22-29 1998;98(25):2936-48. [Medline].

  23. Carroll KC, Cheeseman SH. Infective endocarditis and infections of intracardiac prosthetic devices. In: Irwin and Rippe's Intensive Care Medicine. Lippincott Williams & Wilkins; 2003:1000-15.

  24. Croft LB, Donnino R, Shapiro R, et al. Age-related prevalence of cardiac valvular abnormalities warranting infectious endocarditis prophylaxis. Am J Cardiol. Aug 1 2004;94(3):386-9. [Medline].

  25. Dunmire SM. Infective endocarditis and acquired valvular heart disease. In: Emergency Medicine Concepts and Clinical Practice. Vol 2. Mosby-Year Book; 1998:1745-54.

  26. Durack DT. Prevention of infective endocarditis. N Engl J Med. Jan 5 1995;332(1):38-44. [Medline].

  27. Fowler Jr. VG, Scheld WM, Bayer AS. Endocarditis and intravascular infections. In: Principles and Practice of Infectious Diseases. 6th ed. Elsevier Churchill Livingstone; 2005:975-1022.

  28. Gilbert DN, Moellering RC, Sande MA. The Sanford Guide to Antimicrobial Therapy. 2002:18-21.

  29. Heiro M, Nikoskelainen J, Engblom E. Neurologic manifestations of infective endocarditis: a 17-year experience in a teaching hospital in Finland. Arch Intern Med. Oct 9 2000;160(18):2781-7. [Medline].

  30. Karchmer AW. Infective endocarditis. In: Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 7th ed. WB Saunders Co; 2005:1633-1658.

  31. Karchmer AW. Infective endocarditis. In: Harrison's Principles of Internal Medicine. 16th ed. McGraw-Hill; 2005:731-40.

  32. Miro JM, del Rio A, Mestres CA. Infective endocarditis in intravenous drug abusers and HIV-1 infected patients. Infect Dis Clin North Am. Jun 2002;16(2):273-95, vii-viii. [Medline].

  33. Mylonakis E, Calderwood SB. Infective endocarditis in adults. N Engl J Med. Nov 1 2001;345(18):1318-30. [Medline].

  34. Shively BK. Infective Endocarditis. Curr Treat Options Cardiovasc Med. Feb 2001;3(1):25-35. [Medline].

  35. Stryjewski ME, Chu VH, Cabell CH. Issues in the Management of Endocarditis Caused by Resistant Gram-positive Organisms. Curr Infect Dis Rep. Aug 2004;6(4):283-291. [Medline].

[ CLOSE WINDOW ]

Contributor Information and Disclosures

Author

Keith A Marill, MD, Faculty, Department of Emergency Medicine, Massachusetts General Hospital
Keith A Marill, MD is a member of the following medical societies: American Academy of Emergency Medicine and Society for Academic Emergency Medicine
Disclosure: Medtronic Ownership interest None; Cambridge Heart, Inc. Ownership interest None

Medical Editor

Steven A Conrad, MD, PhD, Chief, Department of Emergency Medicine; Chief, Multidisciplinary Critical Care Service, Professor, Department of Emergency and Internal Medicine, Louisiana State University Health Sciences Center
Steven A Conrad, MD, PhD is a member of the following medical societies: American College of Chest Physicians, American College of Critical Care Medicine, American College of Emergency Physicians, American College of Physicians, International Society for Heart and Lung Transplantation, Louisiana State Medical Society, Shock Society, Society for Academic Emergency Medicine, and Society of Critical Care Medicine
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

Jon Mark Hirshon, MD, MPH, Associate Professor, Department of Emergency Medicine, University of Maryland School of Medicine
Jon Mark Hirshon, MD, MPH is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American College of Emergency Physicians, American Public Health Association, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

CME Editor

John D Halamka, MD, MS, Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center
John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Chief Editor

Barry E Brenner, MD, PhD, FACEP, Professor of Emergency Medicine, Professor of Internal Medicine, Program Director, Emergency Medicine, University Hospitals, Case Medical Center
Barry E Brenner, MD, PhD, FACEP is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American College of Chest Physicians, American College of Emergency Physicians, American College of Physicians, American Heart Association, American Thoracic Society, Arkansas Medical Society, New York Academy of Medicine, New York Academy of Sciences, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

 
 
HONcode

We subscribe to the
HONcode principles of the
Health On the Net Foundation

All material on this website is protected by copyright, Copyright© 1994- by Medscape.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.