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INFECTIVE ENDOCARDITIS
Infective endocarditis is microbial infection of the endovascular structures of the heart.
It often presents in an occult fashion and early diagnosis depends on a high index of clinical suspicion especially in patients with congenital heart disease, prosthetic valves or previous infective endocarditis.
The established diagnosis of infective endocarditis is demonstrated by a positive blood culture and involvement of the endocardium detected during sepsis or systemic infection. It may also be established if there is involvement of the endocardium detected during sepsis or systemic infection but blood culture is negative.

Follow Up

  • Daily exam including temperature and periodic blood tests to monitor for signs of infection
    • Temperature should normalize within 5-10 days with uncomplicated infective endocarditis (IE)
  • Continue to monitor for cardiac murmurs, blood pressure (BP), signs of heart failure (HF) and embolism in the central nervous system (CNS), lungs, spleen and skin
  • Secondary infections in joint and spine may occur
  • C-reactive protein (CRP) decreases rapidly during first or second week of therapy but may stay slightly elevated for 4-6 weeks or longer
    • Persistently high CRP typically means an inadequately controlled infection
  • Normalization of white blood cells (WBC) should also occur within 1-2 weeks
    • Persistently elevated WBC indicates active infection
  • Monitor renal function
  • Good oral and overall hygiene are recommended for risk reduction

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