CardiovascularPending review

Infective Endocarditis

Bloodstream bacteria seed a damaged or abnormal endocardial surface and become trapped in a platelet-fibrin vegetation that shields them from the immune system, so the disease is driven simultaneously by local valve destruction, embolisation of vegetation fragments, and immune complex deposition at distant sites.

In a nutshell

Bacteraemia seeds a platelet-fibrin nidus on damaged or turbulent endothelium, forming an avascular vegetation that shields bacteria from the immune system and requires prolonged IV antibiotics to clear. Disease features split into local valve destruction, distal embolisation of vegetation fragments, and immune complex deposition at distant sites.

Classic presentation

A patient with a predisposing valve lesion or intravenous drug use presents with persistent fever, a new murmur, and splinter haemorrhages or other peripheral stigmata.

Key points

The vegetation is avascular and shielded from the immune system, which is why prolonged high-dose IV antibiotics (not a short oral course) are required.

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Educational content pending clinical review. Not medical advice.