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Infective endocarditis (IE)

See also [IDSA: IE Management 2015](/Infectious Diseases/IDSA Guidelines/IE Management 2015/IE Management 2015.md)

Diagnosis

  • Infection of heart valves

Organisms

  • Staphylococcus aureus
  • Viridans group streptococci
  • Coagulase-negative staphylococci
  • Other streptococci
  • Enterococci
  • HACEK group
  • Fungi

Presentation

  • [Modified Duke criteria](Modified Duke criteria.md)
  • IVDU: Viridans group streptococci and Pseudomonas aeroginosa
  • Colon cancer: Streptococcus bovis and Clostridium septicum

Treatment

  • MSSA native valve endocarditis
    • Cloxacillin or cefazolin
    • OR vanco/dapto
  • MSSA prosthetic valve endocarditis
    • Clox PLUS rifampin PLUS 2 weeks of gentamicin
    • OR vanco/dapto, other things
    • 6 weeks

References

  1. ^  Kasper Iversen, Nikolaj Ihlemann, Sabine U. Gill, Trine Madsen, Hanne Elming, Kaare T. Jensen, Niels E. Bruun, Dan E. Høfsten, Kurt Fursted, Jens J. Christensen, Martin Schultz, Christine F. Klein, Emil L. Fosbøll, Flemming Rosenvinge, Henrik C. Schønheyder, Lars Køber, Christian Torp-Pedersen, Jannik Helweg-Larsen, Niels Tønder, Claus Moser, Henning Bundgaard. Partial Oral versus Intravenous Antibiotic Treatment of Endocarditis. New England Journal of Medicine. 2019;380(5):415-424. doi:10.1056/nejmoa1808312.
  2. ^  John A Wildenthal, Andrew Atkinson, Sophia Lewis, Sena Sayood, Nathanial S Nolan, Nicolo L Cabrera, Jonas Marschall, Michael J Durkin, Laura R Marks. Outcomes of Partial Oral Antibiotic Treatment for Complicated Staphylococcus aureus Bacteremia in People Who Inject Drugs. Clinical Infectious Diseases. 2022;76(3):487-496. doi:10.1093/cid/ciac714.
  3. ^  Sarah Freling, Noah Wald-Dickler, Josh Banerjee, Catherine P Canamar, Soodtida Tangpraphaphorn, Dara Bruce, Kusha Davar, Fernando Dominguez, Daniel Norwitz, Ganesh Krishnamurthi, Lilian Fung, Ashley Guanzon, Emi Minejima, Michael Spellberg, Catherine Spellberg, Rachel Baden, Paul Holtom, Brad Spellberg. Real-World Application of Oral Therapy for Infective Endocarditis: A Multicenter, Retrospective, Cohort Study. Clinical Infectious Diseases. 2023;77(5):672-679. doi:10.1093/cid/ciad119.