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Types and Causes of Infective Endocarditis


Types and Causes

Types of Infective Endocarditis

Acute infective endocarditis develops suddenly and may become life threatening within days. S. aureus is now the most common cause of infective endocarditis globally.

Infective endocarditis has been arbitrarily categorized as acute or subacute based on the length of symptoms before presentation. A classification based on the causative organism and the valve involved is more relevant clinically.

  • Acute infective endocarditis develops suddenly and may become life threatening within days.
  • Subacute infective endocarditis or subacute bacterial endocarditis develops gradually. It may take a period of weeks to several months to evolve.

Causes of Infective Endocarditis

Infectious Endocarditis is usually caused by bacteria. Bacteria belonging to groups called staphylococci, streptococci, or enterococci account for about 90 % of the cases. S. aureus is now the most common cause of infective endocarditis globally. Fungi belonging to the Aspergillus and Candida species also cause IE. Pseudomonas and Serratia are rarer causes.

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Bacteria (or fungi) may be introduced into the bloodstream by various means. The pathogens can then lodge on heart valves and infect the endocardium (the lining of the heart chambers). Medical procedures, including dental procedures serve as portals of entry for the pathogens. Infection most commonly occurs in already damaged, abnormal or artificial valves. Some aggressive bacteria may affect normal valves.

Causes may be listed as:

  • Injury to the skin, lining of the mouth, or gums (even the minor injuries caused during chewing or brushing can serve as entry points)
  • Gingivitis (inflammation of the gums) with infection, minor skin infections, and infections elsewhere in the body
  • Surgical, dental, and medical procedures: Dental procedures most commonly introduce the organism Streptococcus viridans
  • Injection of illicit drugs or prolonged use of intravenous lines
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