Open Access Medical Books



Edited by Steven W. Kerrigan .

132 pages .
Open Access .
ISBN 978-953-51-1169-6 .

Infective Endocarditis is considered to be the fourth leading cause of life threatening infectious disease, and is associated with significant morbidity and mortality. It typically develops in individuals with an underlying cardiac defect, and usually occurs in close proximity to lesions subjected to hemodynamic disturbance. These lesions have the ability to generate turbulent blood flow, which in turn can damage the endothelial surface, exposing the subendothelial matrix. This area becomes highly thrombogenic, leading to platelet deposition and the formation of a fibrin network. This sterile platelet fibrin nidus, in turn, recruits bacteria from either a distal source or from a focal infection resulting from transient bacteraemia.
Finally, secondary accumulation of platelets encase the bacteria forming a septic thrombus rendering them safe from immune attack. Thrombus formation can lead to aortic valve leaflet perforation that can manifest itself as acute congestive heart failure.
Treatment of infective endocarditis usually requires a multidisciplinary approach involving specialists in infectious disease, cardiologists and cardiac surgeons. Current treatment regimes consist of aggressive prolonged antibiotic therapy, frequently combined with surgery.
Prolonged antibiotic use is often less than successful as 40% of patients relapse within 2 months of finishing clinically effective therapy. Furthermore, prolonged exposure to antibiotics leads to a greater risk of adding to the global problem of multiple antibiotic resistant strains of bacteria. Surgery is a costly and risky alternative, however necessary in up to 47% of patients. In many cases surgery is not preferable due to risks associated with cardiac failure, further spread of infection leading to persistent sepsis due to surgical removal of an infected thrombus and/or life threatening embolisation.
Significant advances have been made recently in our understanding of the molecular mechanisms leading to disease progression thus the primary intent in producing this book is to elevate awareness and enthusiasm in the field. It is based on these recent advances that I hope it will provide greater understanding of the challenges this complex disease brings.

Dr. Steven W. Kerrigan
Principal Investigator,
Cardiovascular Infection Group,
Royal College of Surgeons in Ireland,
Dublin, Ireland


 1 Complications of Endocarditis 1 Yongping Wang and Aifeng Wang

 2 Platelet-Bacterial Interactions in the Pathogenesis of Infective Endocarditis — Part I: The Streptococcus 13 Dorothea Tilley and Steven W. Kerrigan

 3 Platelet Bacterial Interactions in the Pathogenesis of Infective Endocarditis — Part II: The Staphylococcus 35 Steven W. Kerrigan

 4 History of Antimicrobial Prophylaxis Protocols for Infective Endocarditis Secondary to Dental Procedures 53 Inmaculada Tomás and Maximiliano Álvarez-Fernández

 5 Surgical Management of Infective Endocarditis 85 Nicholas Kang and Warren Smith

 6 New Treatment Modalities for Ocular Complications of Endocarditis 105 Ozlem Sahin

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Published by: Unknown - Friday, June 28, 2013


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