ICU · Cardiovascular / infection

Infective Endocarditis

Also known as Infective endocarditis · IE · Bacterial endocarditis · Duke criteria · Vegetation · Osler nodes · Janeway lesions · HACEK · Culture-negative endocarditis

Infective endocarditis is an infection of the cardiac valves (or the endocardium), diagnosed by the modified Duke criteria: typical positive blood cultures and an echocardiographic vegetation are the major criteria. The commonest ICU organism is Staphylococcus aureus (aggressive, acute); viridans streptococci cause subacute endocarditis (dental); enterococci, the HACEK group, and culture-negative organisms (Coxiella, Bartonella, fungi) are also important. The clinical features: fever, a new or changed murmur, embolic phenomena (stroke, splenic, mesenteric, limb), immunological phenomena (Osler nodes, Roth spots, glomerulonephritis), and vascular phenomena (Janeway lesions). The treatment is 4-6 weeks of IV antibiotics (targeted to the culture). Surgery is indicated for heart failure (the commonest indication), uncontrolled infection, large vegetations with embolism, and perivalvular extension.

Checked against its sources on 14 Oct 2026