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Infective endocarditis is an infection of the inner surface of the heart (endocardium), usually the valves. [1] Signs and symptoms may include fever , small areas of bleeding into the skin , heart murmur , feeling tired, and low red blood cell count .
Another form of sterile endocarditis is termed Libman–Sacks endocarditis; this form occurs more often in patients with lupus erythematosus and is thought to be due to the deposition of immune complexes. [2] Like NBTE, Libman-Sacks endocarditis involves small vegetations, while infective endocarditis is composed of large vegetations. [2]
Currently, there are official guidelines for dental antibiotic prophylaxis for the prevention of infective endocarditis and of infection of prosthetic joint. These guidelines are in constant controversy and revisions by various professional committees.
Based on previous studies, though, the risk of endocarditis following cutaneous surgery is low and thus the use of antibiotic prophylaxis is controversial. Although this practice is appropriate for high-risk patients when skin is contaminated, it is not recommended for noneroded, noninfected skin.
Infective endocarditis used to be classified into groups like acute and subacute based on how quickly the infection developed, but nowadays the key is to identify that microbial cause of infection and to treat it as effectively as possible. Viridans Streptococci is the most common cause.
Other strains of streptococci can cause subacute endocarditis as well. These include streptococcus intermedius, which can cause acute or subacute infection (about 15% of cases pertaining to infective endocarditis). [7] Enterococci from urinary tract infections and coagulase negative staphylococci can also be causative agents. [5]
Official guidelines by the American Heart Association for dental antibiotic prophylaxis call for the administration of antibiotics to prevent infective endocarditis. Though the current (2007) guidelines dictate more restricted antibiotic use, many dentists [38] and dental patients [39] follow the 1997 guidelines instead, leading to overuse of ...
This risk is approximately three-to eightfold the risk of infective endocarditis in the general population. [4] Until 2007, the American Heart Association recommended prescribing antibiotics before invasive procedures, including those in dental surgery.