Weisse found that 13% of 121 patients had endocarditis. Marantz also found a prevalence of endocarditis of 13% among such patients in the emergency department 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.Among people with staphylococcal bacteremia (SAB), one study found a 29% prevalence of endocarditis in community-acquired SAB versus 5% in nosocomial SAB. However, only 2% of strains were resistant to methicillin and so these numbers may be low in areas of higher resistance. Prevention
Not all people with heart disease require antibiotics to prevent infective endocarditis. Heart diseases have been classified into high, medium and low risk of developing IE. Those falling into high risk category require IE prophylaxis before endoscopies and urinary tract procedures. Diseases listed under high risk include:
Prior endocarditis
Unrepaired cyanotic congenital heart diseases
Completely repaired congenital heart disease in their first 6 months
Prosthetic heart valves
Incompletely repaired congenital heart diseases
Cardiac transplant valvulopathyFollowing are the antibiotic regimens recommended by the American Heart Association for antibiotic prophylaxis:
Oral amoxicillin one hour before the procedure
Intravenous or intramuscular ampicillin one hour before the procedure
In patients allergic to penicillins
Azithromycin or clarithromycin orally one hour before the procedure
Cephalexin orally one hour before the procedure
Clindamycin orally one hour before the procedureIn the UK, NICE clinical guidelines no longer advise prophylaxis because there is no clinical evidence that it reduces the incidence of IE and there are negative effects (e.g.
Although a history of valve disease has a significant association with infective endocarditis, 50% of all cases develop in people with no known history of valvular disease. History
Few diseases present greater difficulties in the way of diagnosis than malignant endocarditis, difficulties which in many cases are practically insurmountable. It is no disparagement to the many skilled physicians who have put their cases upon record to say that, in fully one-half the diagnosis was made post mortem. Lazare Riviére first described infective endocarditis affecting the aortic valve in 1616. In 1806, Jean-Nicolas Corvisart coined the term vegetation to describe collections of debris found on a mitral valve affected by infective endocarditis. The British physician Joseph Hodgson was the first to describe the embolic complications of infective endocarditis in 1815. It was not until 1878 that Theodor Klebs first suggested that infective endocarditis had a microbial infectious origin. In 1909, William Osler noted that heart valves that experienced degeneration and were sclerotic or poorly functioning had a higher risk of being affected. Later, in 1924, Emanuel Libman and Benjamin Sacks described cases of vegetative endocarditis that lacked a clear microbial origin and were often associated with the autoimmune condition systemic lupus erythematosus. In 1944, physicians reported on the first successful use of penicillin to treat a case of infective endocarditis. References
External links

Infective endocarditis at Curlie