|
|
| Line 19: |
Line 19: |
| There has been a decline in [[streptococcus viridans]] endocarditis and an increase in staphylococcal endocarditis. | | There has been a decline in [[streptococcus viridans]] endocarditis and an increase in staphylococcal endocarditis. |
|
| |
|
| ==Risk Factors for Endocarditis==
| |
| Adults and children with underlying cardiac conditions placing them at highest risk for adverse outcomes of infective endocarditis (IE) including those with:
| |
| * Prosthetic cardiac valve or prosthetic cardiac valve repair
| |
| * Previous infective endocarditis
| |
| * Congenital heart disease (CHD) associated with
| |
| ** Unrepaired cyanotic CHD, including palliative shunts and conduits
| |
| ** Completely repaired congenital heart defect with prosthetic material or device, whether placed by surgery or by catheter intervention, during the first 6 months after the procedure
| |
| ** Repaired CHD with residual defects at the site or adjacent to the site of a prosthetic patch or prosthetic device (which inhibit endothelialization)
| |
| * Cardiac transplantation patients who develop cardiac valvulopathy
| |
|
| |
| ====What is the Incidence among Patients who do not use Illicit Drugs and have a [[Fever]] in the Emergency Room?====
| |
| There is less than a 5% chance of occult endocarditis. Mellors in 1987 found no cases of endocarditis nor of [[staphylococcal]] bacteremia among 135 febrile patients in the emergency room. The upper [http://medinformatics.uthscsa.edu/calculator/calc.shtml confidence interval] for an incidence of 0% among 135 patients is 5%, statistically there is up to a 5% chance of endocarditis among these patients. In contrast, Leibovici found that among 113 non-selected adults admitted to the hospital because of fever there were two cases (1.8% with 95%CI: 0% to 7%) of [[endocarditis]].
| |
|
| |
| ====What is the Incidence among Patients who do use Illicit Drugs and have a Fever in the Emergency Room?====
| |
| There is about a 10% to 15% prevalence of [[endocarditis]]. This estimate is not substantially changed by whether the doctor believes the patient has a trivial explanation for their fever. Weisse found that 13% of 121 patients had endocarditis. Marantz also found a prevalence of endocarditis of 13% among such patients in the emergency room with fever. Samet found a 6% incidence among 283 such patients, but after excluding patients with initially apparent major illness to explain the fever (including 11 cases of manifest endocarditis), there was a 7% prevalence of endocarditis.
| |
|
| |
| ====What is the Incidence among Patients with Staphylococcal Bacteremia (SAB)====
| |
| One study found a 29% prevalence of [[endocarditis]] in community-acquired SAB versus 5% in nosocomial SAB<ref name=Kaech>{{cite journal | author = Kaech C, Elzi L, Sendi P, Frei R, Laifer G, Bassetti S, Fluckiger U | title = Course and outcome of Staphylococcus aureus bacteraemia: a retrospective analysis of 308 episodes in a Swiss tertiary-care centre. | journal = Clin Microbiol Infect | volume = 12 | issue = 4 | pages = 345-52 | year = 2006 | id = PMID 16524411 | doi=10.1111/j.1469-0691.2005.01359.x}}</ref>. However, only 2% of strains were resistant to [[methicillin]] and so these numbers may be low in areas of higher resistance.
| |
|
| |
|
| ==References== | | ==References== |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
The incidence of infective endocarditis is approximately 2-4 cases per 100,000 persons per year worldwide. The prevalence of infective endocarditis among IV drug users ranges from 10 to 15%.
Epidemiology and Demographics
Incidence
The incidence of infective endocarditis is approximately 2-4 cases per 100,000 persons per year worldwide. This rate has not changed in the past 5-6 decades.
Age
Infective endocarditis may occur in a person of any age. The frequency is increasing in elderly individuals, with 25-50% of cases occurring in those older than 60 years of age.
Gender
Infective endocarditis is 3 times more common in males than in females.
Changes in Bacterial Species Causing Endocarditis
There has been a decline in streptococcus viridans endocarditis and an increase in staphylococcal endocarditis.
References
Template:WH
Template:WS