[Infectious endocarditis: strategy for diagnosis].

Infectious endocarditis: STRATEGY FOR DIAGNOSIS. The diagnosis of infective endocarditis is often difficult because the clinical presentations are very heterogeneous. Epidemiology has evolved with more acute forms, different microorganisms, and an increase in prevalence in patients with cardiac prosthetic or electronic devices. Diagnosis is based on a clinical suspicion, associated with microbiological data and imaging evidence of lesions of the endocardium. Echocardiography plays a key role, but advanced imaging techniques provide additional information. The 2023 European Society of cardiology (ESC) recommendations like those of 2015 confirmed the essential role of multimodal imaging, integrating lesions highlighted by any imaging technique as major criteria. The diagnostic criteria have thus been modified to consider new epidemiological and imaging data. Different diagnostic strategy algorithms are proposed depending on whether the patient has prosthetic material or not. The endocarditis team is the keystone in this diagnostic approach to improve patient management.