Infective endocarditis: changing aetiology of disease

Infective endocarditis (IE) is an evolving disease resulting in high morbidity and mortality. Despite medical and diagnostic advances, the incidence of the disease has remained unchanged, reflecting the changing epidemiological and microbiological profile of IE. Classical risk factors such as rheumatic heart disease have now been overtaken by new risk factors including an ageing population, degenerative valve disease and intravenous drug use. The routine use of invasive procedures, implantable cardiac devices and prosthetic heart valves has served to increase the number of at-risk patients. The microbiology of IE mirrors the changing risk factors, with staphylococcal infections predominating over viridans streptococci. An overview of this rare disease is given describing current understanding, investigation and changing epidemiology and microbiology of IE.