SUBACUTE BACTERIAL ENDOCARDITIS PROPHYLAXIS

Course overview

INFECTIVE ENDOCARDITIS (IE) IS AN INFECTION OF THE ENDOCARDIAL SURFACES OF THE HEART, WHICH INCLUDES ONE OR MORE HEART VALVES. THE INCIDENCE OF INFECTIVE ENDOCARDITIS HOSPITALIZATION IN THE UNITED STATES IS ESTIMATED AT 12.7 PER 100,000 ANNUALLY. MOST OF THE PATIENTS (57.7%) ARE MALE, AND MORE THAN A THIRD ARE 70 YEARS AND OLDER. SEVERAL RISK FACTORS PREDISPOSE PATIENTS TO IE, SUCH AS STRUCTURAL HEART DISEASE (VALVULAR DISEASE OR CONGENITAL HEART DISEASE), PROSTHETIC HEART VALVES, INDWELLING CARDIOVASCULAR DEVICE, AN INTRAVASCULAR CATHETER, CHRONIC HEMODIALYSIS, HUMAN IMMUNODEFICIENCY VIRUS INFECTION, DIABETES, OR HISTORY OF INFECTIVE ENDOCARDITIS. IN ADDITION, INFECTIVE ENDOCARDITIS MAY PRESENT AS ACUTE OR SUBACUTE INFECTION. ACUTE INFECTIONS PRESENT AS A RAPIDLY PROGRESSIVE DISEASE WITH HIGH FEVERS, RIGORS, AND SEPSIS. ON THE OTHER HAND, SUBACUTE BACTERIAL ENDOCARDITIS DIAGNOSIS IS OFTEN DELAYED AND PRESENTS WITH NON-SPECIFIC SYMPTOMS SUCH AS WEIGHT LOSS, FATIGUE, AND DYSPNEA OVER SEVERAL WEEKS TO MONTHS. THERE ARE SEVERAL DIFFERENCES BETWEEN SUBACUTE BACTERIAL ENDOCARDITIS AND ACUTE BACTERIAL ENDOCARDITIS. MOST CASES OF SUBACUTE BACTERIAL ENDOCARDITIS ARE CAUSED BY PENICILLIN-SENSITIVE STREPTOCOCCUS VIRIDANS, WHILE STAPHYLOCOCCUS AUREUS CAUSES MOST CASES OF ACUTE BACTERIAL ENDOCARDITIS. THIS ACTIVITY REVIEWS THE PROPHYLAXIS OF SUBACUTE ENDOCARDITIS AND HIGHLIGHTS THE ROLE OF THE INTERPROFESSIONAL TEAM APPROACH.