What are the primary causes of endocarditis pathogenesis?
The primary causes of endocarditis pathogenesis include damaged or denuded endothelium, Gram-positive cocci expressing adhesins as virulence factors, nonbacterial thrombotic endocarditis (NBTE), intravenous catheters, illicit intravenous drug use, and cardiovascular implantable electronic device leads. Damage to the endothelium occurs by two mechanisms: direct damage produced by the foreign body rubbing directly against the endothelial surface, or via an indirect effect such as when a foreign device interferes with normal tricuspid valve function and causes regurgitant jets of blood. Bacteremia can also be caused by entry of organisms at the skin site of percutaneous catheters or leads, via the catheter lumen, or in contaminated infusate.