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Previous Volume 345:1318-1330 November 1, 2001 Number 18 Next

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Infective endocarditis, a microbial infection of the endocardial surface of the heart, has been classified as "acute" or "subacute–chronic" on the basis of the tempo and severity of the clinical presentation and the progression of the untreated disease. The characteristic lesion, a vegetation, is composed of a collection of platelets, fibrin, microorganisms, and inflammatory cells. It most commonly involves heart valves but may also occur at the site of a septal defect, on the chordae tendineae, or on the mural endocardium.

This report will focus on progress made over the past decade in the diagnosis and management of endocarditis affecting . . . [Full Text of this Article]

Epidemiologic Features and Predisposing Factors

Infective Endocarditis of Native Valves

Infective Endocarditis of Prosthetic Valves

Nosocomial Infective Endocarditis

Microbiologic Features

Clinical Manifestations

Diagnosis

The Duke Criteria

Echocardiography

Patients with Staph. aureus Bacteremia

Complications

Cardiac Complications

Neurologic Complications

Systemic Emboli and Splenic Abscess

Prolonged Fever

Treatment

Choice of Antimicrobial Agents

Antimicrobial-Susceptibility Testing

Anticoagulant Therapy

Surgical Therapy

Mortality and Relapse

Conclusions

Source Information

From the Division of Infectious Diseases, Massachusetts General Hospital, Boston (E.M., S.B.C.); and the Department of Microbiology and Molecular Genetics, Harvard Medical School, Boston (S.B.C.).

Address reprint requests to Dr. Calderwood at the Division of Infectious Diseases, Massachusetts General Hospital, Boston, MA 02114.

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