内科学教学课件：Infective Endocarditis (IE).pptVIP

Infective Endocarditis (IE) generalizationinfective endocarditis is formed by microbic excrescence on inner layer of the heart, the endocardium. The most common structures involved are the heart valves, defective septum, chordae tendineae and heart wall intimae. According to course of diseases acute or subacuteAccording to etiologyNative valve endocarditisProsthetic valve endocarditisEndocarditis in intravenous drug abuserskinds Native valve endocarditisEtiology: native valve endocarditis of streptococcus and Staphylococcus aureus is 65% and 25% respectively.Acute IE: mainly caused by staphylococcus aureusSubacute IE: viridans group of streptococci is the most common prosthetic valve endocarditisearly stage of prosthetic valve endocarditis (often staphylococcus): Less than 60 days after cardiac operation Later stage of prosthetic valve endocarditis (often viridans group of streptococci ): 60 days or more after cardiac operation, except that excrescence or vegetations is formed, artificial valve is damaged, the aortic valve is involved most commonly. endocarditis in intravenous drug abusersCommonly seen in young maleoriginating from skin infections, the main causative organism is Staph. Aureuspreviously normal valve is involvedbeyond 50% of the patient show tricuspid damage. Mechanism of NVESubacute form account for at least 2/3 of the cases, the following factors are concerned: 1. HemodynamicsMany acquired and congenital cardiac lesions are vulnerable to endocarditis, particularly areas of endocardial damage caused by a high-pressure jet of blood such as ventricular septal defect, mitral regurgitation and aortic regurgitation, many of which are haemodynamically insignificant. platelet micro thrombus and fibrin accumulate nodular nonbacterial excrescence, which is important factor to bacteria locate valve surface.2. Nonbacterial thrombus endocarditis 3. Transient bacteremiaAll kinds of infection or wound at skin and mucosa with bacteria often cause it, such as op