Infective Endocarditis

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Dr. M. Seshadri Reddy, MD*

Definition

Condition in which there is microbial infection of the endothelial surface of the heart.

Case

A 40 year old Agriculturist comes to the casualty with history of fever which was high grade and continuous for the past 3 weeks. There was no history of any cough, burning micturition or septic focus in the body. He had been treated outside with various antibiotics and anti malarials. No prior major illnesses which warranted admissions. No history/of diabetes mellitus and hypertension. He has been a chronic smoker and an alcoholic. On examination he looked toxic and delirious with a high fever (103oF). His general examination showed grade III clubbing, splinter haemorrhages in his nail beds with purpuric rashes on his finger tips. Examination of his abdomen showed a splenomegaly. Auscultation of his heart revealed a ejection systolic murmur in his aortic, pulmonary area, and early diastolic murmur in the aortic and second aortic area.

Discussion :

This is a person with fever of three weeks duration, with a general examination revealing a high fever, clubbing, splinter haemorrhages and purpuric rashes. The systemic examination
shows new cardiac murmurs in a person not previously known to have a cardiac lesion. Abdominal examination revealing a splenomegaly. A provisional diagnosis of infective endocarditis was made and after taking blood cultures and Echo was sought which revealed a large vegetation on the aortic valve causing aortic regurgitation. This is a case of Native Valve Endocarditis.

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