New approach to managing infective endocarditis

Despite significant diagnostic and therapeutic improvements, infective endocarditis (IE) still carries high morbidity and mortality. In the last three decades, significant variations in epidemiological and clinical profile of IE have been observed. The diagnosis of IE requires an adequate clinical suspicion, given its pleomorphic presentation. Microbiological and imaging techniques, which are pivotal in confirming the diagnosis, need constant refinement because of suboptimal accuracy. A clinically integrated multidisciplinary approach is recommended. Guidelines provide useful support despite being based mainly on the opinion of experts rather than on randomized trials, with some inconsistencies among different recommendations. This review encounters the current state of knowledge, gaps in evidence, and future research direction in the field of IE.