Pub Date : 2019-06-17DOI: 10.5772/INTECHOPEN.86395
Måns Almqvist, Gustav Mattsson, R. Razmi, P. Magnusson
The use of cardiac devices, that is, pacemakers and implantable cardioverter defibrillators, has increased, and the incidence will likely continue to increase due to an aging population with associated risk factors. Unfortunately, this implies an increasing number of complications, including infections. Cardiac device-related infection is a dreaded complication causing both increased morbidity and mortality, and considerable costs. Because of the presence of a foreign body in subcutaneous tissue, vasculature, and the heart, patients with cardiac device systems are at increased risk of endocarditis due to microbial agents. In general, an infected device system should be removed in its entirety. The timing of reimplantation varies due to indication and severity of the infection. Furthermore, the explant procedure may be complicated and should be performed by an experienced team including facilities to handle life-threatening complications. The subcutaneous implantable cardioverter defibrillator or leadless pacemaker can serve as an option in selected cases. This chapter will describe clinical aspects of cardiac device-related infections.
{"title":"Cardiac Implantable Electronic Device-Related Infections","authors":"Måns Almqvist, Gustav Mattsson, R. Razmi, P. Magnusson","doi":"10.5772/INTECHOPEN.86395","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.86395","url":null,"abstract":"The use of cardiac devices, that is, pacemakers and implantable cardioverter defibrillators, has increased, and the incidence will likely continue to increase due to an aging population with associated risk factors. Unfortunately, this implies an increasing number of complications, including infections. Cardiac device-related infection is a dreaded complication causing both increased morbidity and mortality, and considerable costs. Because of the presence of a foreign body in subcutaneous tissue, vasculature, and the heart, patients with cardiac device systems are at increased risk of endocarditis due to microbial agents. In general, an infected device system should be removed in its entirety. The timing of reimplantation varies due to indication and severity of the infection. Furthermore, the explant procedure may be complicated and should be performed by an experienced team including facilities to handle life-threatening complications. The subcutaneous implantable cardioverter defibrillator or leadless pacemaker can serve as an option in selected cases. This chapter will describe clinical aspects of cardiac device-related infections.","PeriodicalId":417704,"journal":{"name":"Infective Endocarditis","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125747079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-03-24DOI: 10.5772/INTECHOPEN.85019
Adrián Fernando Narvaez Muñoz, D. Vargas
Infective endocarditis (IE) at the right side represents the 5 – 10% of IE cases. It is more frequent in people with intravenous drug addiction (IVDA); however, there is another population susceptible to this infection; hemodialytic patients, intracardiac devices, and congenital heart diseases are included inside this group. Right-sided infective endocarditis (RSIE) has lower mortality than the left-sided infective endocarditis (LSIE). Common symptoms secondary to right-sided endocarditis are the respiratory symptoms characterized by a cough, hemoptysis, persistent fever, dyspnea, and chest pain. Echocardiography and blood cultures are the first tools to perform the diagnosis. The tricuspid valve is the main anatomical structure affected. Medical treatment with antibiotic therapy resolves the infection majority of the time; the surgical treatment is indicated in some cases, such as right-heart failure due to severe tricuspid valve regurgitation; inability to eliminate bacteremia or organism; resistance to culture-directed antibiotic treatment, within 7 days; and tricuspid valve vegetations >20 mm. RSIE implies a better prognosis than LSIE. Concomitant left-sided IE carries a worse prognosis than right-sided infection alone, due predominantly to its greater likelihood for invasion and abscess formation.
{"title":"Right-Sided Infective Endocarditis","authors":"Adrián Fernando Narvaez Muñoz, D. Vargas","doi":"10.5772/INTECHOPEN.85019","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.85019","url":null,"abstract":"Infective endocarditis (IE) at the right side represents the 5 – 10% of IE cases. It is more frequent in people with intravenous drug addiction (IVDA); however, there is another population susceptible to this infection; hemodialytic patients, intracardiac devices, and congenital heart diseases are included inside this group. Right-sided infective endocarditis (RSIE) has lower mortality than the left-sided infective endocarditis (LSIE). Common symptoms secondary to right-sided endocarditis are the respiratory symptoms characterized by a cough, hemoptysis, persistent fever, dyspnea, and chest pain. Echocardiography and blood cultures are the first tools to perform the diagnosis. The tricuspid valve is the main anatomical structure affected. Medical treatment with antibiotic therapy resolves the infection majority of the time; the surgical treatment is indicated in some cases, such as right-heart failure due to severe tricuspid valve regurgitation; inability to eliminate bacteremia or organism; resistance to culture-directed antibiotic treatment, within 7 days; and tricuspid valve vegetations >20 mm. RSIE implies a better prognosis than LSIE. Concomitant left-sided IE carries a worse prognosis than right-sided infection alone, due predominantly to its greater likelihood for invasion and abscess formation.","PeriodicalId":417704,"journal":{"name":"Infective Endocarditis","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122365551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-03-21DOI: 10.5772/INTECHOPEN.84908
P. Rubio, Roberto Molina, P. Avila, A. G. Mora, Cesar A. Lopez
Infective endocarditis is defined by a focus of infection within the heart. Despite the optimal care, the mortality approaches 30% at 1 year, so the care for this type of patients represents a challenge to improve the result in your care. The challenges in this clinical entity have several aspects such as the diversity of germs that cause endocarditis, and the most important epidemiologically has generated resistance to antimicrobial treatment along with the possibility of apoptosis in their host-germ interaction. The immunogenetic susceptibility to host infection is discussed, which represents a deep area of research. Inflammation, local and systemic, is complex, with the genesis of reactive oxygen species, which are harmful when the antioxidant defenses are exceeded, causing the break in the mitochondrial electron transport chain with the fall in energy genesis, multiple organ failure, and death. Both at the cellular level and in the mitochondria, possible therapeutic targets are also commented.
{"title":"Infective Endocarditis: Inflammatory Response, Genetic Susceptibility, Oxidative Stress, and Multiple Organ Failure","authors":"P. Rubio, Roberto Molina, P. Avila, A. G. Mora, Cesar A. Lopez","doi":"10.5772/INTECHOPEN.84908","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.84908","url":null,"abstract":"Infective endocarditis is defined by a focus of infection within the heart. Despite the optimal care, the mortality approaches 30% at 1 year, so the care for this type of patients represents a challenge to improve the result in your care. The challenges in this clinical entity have several aspects such as the diversity of germs that cause endocarditis, and the most important epidemiologically has generated resistance to antimicrobial treatment along with the possibility of apoptosis in their host-germ interaction. The immunogenetic susceptibility to host infection is discussed, which represents a deep area of research. Inflammation, local and systemic, is complex, with the genesis of reactive oxygen species, which are harmful when the antioxidant defenses are exceeded, causing the break in the mitochondrial electron transport chain with the fall in energy genesis, multiple organ failure, and death. Both at the cellular level and in the mitochondria, possible therapeutic targets are also commented.","PeriodicalId":417704,"journal":{"name":"Infective Endocarditis","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116836450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-03-01DOI: 10.5772/INTECHOPEN.84708
Moldovan Horatiu, A. Molnar, V. Costache, E. Bontaș
Intravenous drug use is associated with infective endocarditis. Besides, it does appear that left-sided infective endocarditis is a feature of general population, whereas right-sided infective endocarditis is common in intravenous drug users. The most common etiology of right-sided infective endocarditis in intravenous drug users is Staphylococcus aureus in about 75% followed by streptococci, Gram-negative bacilli and fungi. In case of intravenous drug users with infective endocarditis, optimal treatment strategies lack a general consensus. Additionally, the best indication and timing of surgery are debatable. To overcome these problems, the early and complete surgical debridement of infected tissue together with microbial therapy assures a good prognosis in the long term.
{"title":"Infective Endocarditis in Intravenous Drug Users: Surgical Treatment","authors":"Moldovan Horatiu, A. Molnar, V. Costache, E. Bontaș","doi":"10.5772/INTECHOPEN.84708","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.84708","url":null,"abstract":"Intravenous drug use is associated with infective endocarditis. Besides, it does appear that left-sided infective endocarditis is a feature of general population, whereas right-sided infective endocarditis is common in intravenous drug users. The most common etiology of right-sided infective endocarditis in intravenous drug users is Staphylococcus aureus in about 75% followed by streptococci, Gram-negative bacilli and fungi. In case of intravenous drug users with infective endocarditis, optimal treatment strategies lack a general consensus. Additionally, the best indication and timing of surgery are debatable. To overcome these problems, the early and complete surgical debridement of infected tissue together with microbial therapy assures a good prognosis in the long term.","PeriodicalId":417704,"journal":{"name":"Infective Endocarditis","volume":"366 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132674888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-02-14DOI: 10.5772/INTECHOPEN.84319
R. Meel
Right-sided infective endocarditis is due to intravenous drug abuse. Right-sided infective endocarditis is rare. It comprises 5–10% of infective endocarditis cases. Traditionally, it has been reported more commonly in patients with medical devices such as pacemakers and defibrillators and dialysis catheters. Recently, there has been increase in right-sided infective endocarditis related to intravenous drug abuse. Right-sided infective endocarditis related to drug abuse mostly affects the tricuspid valve and rarely the pulmonary valve. Although, most uncomplicated cases do well with medical treatment, it is associated with considerable morbidity and mortality due to recurrent infection. Surgery for right-sided infective endocarditis is uncommon especially in resource limited setting. Few current studies have explored surgical options in this group of patients. This chapter will review current literature related to right-sided infective endocarditis due to intravenous drug abuse.
{"title":"Right-Sided Infective Endocarditis Secondary to Intravenous Drug Abuse","authors":"R. Meel","doi":"10.5772/INTECHOPEN.84319","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.84319","url":null,"abstract":"Right-sided infective endocarditis is due to intravenous drug abuse. Right-sided infective endocarditis is rare. It comprises 5–10% of infective endocarditis cases. Traditionally, it has been reported more commonly in patients with medical devices such as pacemakers and defibrillators and dialysis catheters. Recently, there has been increase in right-sided infective endocarditis related to intravenous drug abuse. Right-sided infective endocarditis related to drug abuse mostly affects the tricuspid valve and rarely the pulmonary valve. Although, most uncomplicated cases do well with medical treatment, it is associated with considerable morbidity and mortality due to recurrent infection. Surgery for right-sided infective endocarditis is uncommon especially in resource limited setting. Few current studies have explored surgical options in this group of patients. This chapter will review current literature related to right-sided infective endocarditis due to intravenous drug abuse.","PeriodicalId":417704,"journal":{"name":"Infective Endocarditis","volume":"43 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124007111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-03-13DOI: 10.5772/INTECHOPEN.84398
C. Busca-Arenzana, Á. Robles-Marhuenda, L. Ramos-Ruperto, Jorge Álvarez-Troncoso
Non-bacterial thrombotic endocarditis or also called verrucous endocarditis or Libman-Sacks endocarditis or marantic endocarditis is a rare entity, still unknown physiopathology, which is characterized by the formation of sterile vegetations at the valvular structures. These vegetations of platelet aggregates and fibrin are sterile by definition, so for its definitive diagnosis, it is essential to rule out an infectious endocarditis. It is mainly diagnosed by echocardiography in patients with neoplasms or systemic autoimmune diseases. Its main complication is the formation of multi-systemic embolisms, preferably at the brain level, so anticoagulation will be fundamental in the treatment and evolution of non-bacterial thrombotic endocarditis.
{"title":"Non-bacterial Thrombotic Endocarditis","authors":"C. Busca-Arenzana, Á. Robles-Marhuenda, L. Ramos-Ruperto, Jorge Álvarez-Troncoso","doi":"10.5772/INTECHOPEN.84398","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.84398","url":null,"abstract":"Non-bacterial thrombotic endocarditis or also called verrucous endocarditis or Libman-Sacks endocarditis or marantic endocarditis is a rare entity, still unknown physiopathology, which is characterized by the formation of sterile vegetations at the valvular structures. These vegetations of platelet aggregates and fibrin are sterile by definition, so for its definitive diagnosis, it is essential to rule out an infectious endocarditis. It is mainly diagnosed by echocardiography in patients with neoplasms or systemic autoimmune diseases. Its main complication is the formation of multi-systemic embolisms, preferably at the brain level, so anticoagulation will be fundamental in the treatment and evolution of non-bacterial thrombotic endocarditis.","PeriodicalId":417704,"journal":{"name":"Infective Endocarditis","volume":"328 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132714066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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