26. Heart of the Infection - Infective Endocarditis

Infective endocarditis involves bacterial colonization of the heart valves, often forming vegetations that lead to valve dysfunction, embolic events, and systemic immune reactions. Staphylococcus aureus, Streptococcus viridans, and Enterococcus remain the most common causative organisms. Diagnosis relies on the Modified Duke’s Criteria, integrating blood culture results, clinical presentation—such as fever and new heart murmurs—and echocardiographic findings. Management requires prompt hemodynamic stabilization and targeted antibiotic therapy, typically lasting six weeks, with surgical intervention indicated for complications like heart failure, paravalvular abscess, or large mobile vegetations. Multidisciplinary care, including addiction services for patients with histories of intravenous drug use, is essential for long-term recovery. Prophylaxis guidelines for dental procedures have narrowed significantly, now focusing primarily on high-risk populations like those with prosthetic valves or prior endocarditis, rather than those with common valvular conditions like mitral valve prolapse.