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Related Concept Videos

Endocarditis I: Introduction01:25

Endocarditis I: Introduction

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Introduction:Endocarditis is the infection of the endocardium, the inner lining of the heart and its valves. When the heart muscle is involved, the condition is termed myocarditis, while an infection of the outer lining is called pericarditis. Infective endocarditis (IE) primarily affects the endocardium, where pathogens adhere to the valves or lining, forming vegetation that can lead to severe complications. Infective endocarditis occurs when microorganisms, usually bacteria from other body...
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Endocarditis II: Clinical Features of Infective Endocarditis01:25

Endocarditis II: Clinical Features of Infective Endocarditis

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Endocarditis can present various clinical features depending on the causative organism and the patient's underlying health conditions. Initially, the clinical features of infective endocarditis develop gradually, presenting with nonspecific symptoms that can be easily mistaken for other illnesses.General SymptomsEarly symptoms of infective endocarditis are fever, chills, weakness, malaise, fatigue, and weight loss. These symptoms reflect the systemic nature of the infection and the body's...
43
Endocarditis III: Medical Management01:18

Endocarditis III: Medical Management

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Infective endocarditis management involves a multifaceted approach encompassing infection prevention, lifestyle modifications, pharmacological therapy, and surgical management.Infection Prevention:Hand Hygiene: Thorough handwashing is crucial to prevent the spread of infection. Hand hygiene should be performed regularly, especially before and after using the restroom.Oral Hygiene: Good oral hygiene is essential. It includes brushing teeth immediately after waking up and before bed, flossing...
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Endocarditis IV: Nursing Management01:29

Endocarditis IV: Nursing Management

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Infective endocarditis (IE) is a chronic infection of the heart's endocardium, primarily affecting the heart valves. A detailed nursing assessment for a patient with IE involves collecting subjective and objective data to ensure an accurate diagnosis and timely intervention.Subjective DataThe nurse gathers information about the patient's symptoms and complaints during the subjective assessment. Patients with infective endocarditis often report non-specific symptoms that can mimic other...
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Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies01:22

Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies

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The key clinical manifestations of Rheumatic heart disease (RHD) include several distinct cardiac symptoms.Carditis, a hallmark of acute rheumatic fever, involves inflammation of the heart's endocardium, myocardium, and pericardium. Chronic RHD often results from recurrent episodes of carditis. Its symptoms include the following:Murmurs are caused by valvular damage, especially to the mitral and aortic valves. Mitral stenosis or regurgitation is common, with characteristic heart murmurs...
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Acute Coronary Syndrome III: Diagnostic Studies01:30

Acute Coronary Syndrome III: Diagnostic Studies

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Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
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Streptococcus agalactiae infective endocarditis in Canada: a multicenter retrospective nested case control analysis.

Torrance Oravec1, S Annie Oravec2, Jennifer Leigh3

  • 1Division of Infectious Diseases, Department of Medicine, University of British Columbia, 328C Heather Pavilion E, 2733 Heather St. Vancouver, Vancouver, BC, V5Z 3J5, Canada. torrance.oravec@medportal.ca.

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Summary

Infective endocarditis (IE) caused by Streptococcus agalactiae (GBS) is a serious condition. Injection drug use, prosthetic valves, and unknown infection sources are key risk factors for developing GBS IE.

Keywords:
Case controlGroup B StreptococcusInfective endocarditisRetrospectiveStreptococcus agalactiae

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Area of Science:

  • Infectious Diseases
  • Cardiology
  • Microbiology

Background:

  • Infective endocarditis (IE) caused by Streptococcus agalactiae (GBS) is increasingly recognized and linked to severe outcomes and high mortality.
  • Current literature on GBS IE primarily consists of case series, highlighting a need for comparative studies.

Purpose of the Study:

  • To compare characteristics of patients with GBS IE to those with GBS bacteremia without IE.
  • To identify specific risk factors associated with the development of IE in GBS bacteremia patients.

Main Methods:

  • A nested case-control study was conducted over 18 years across seven centers in three Canadian cities.
  • Adult patients with GBS bacteremia were analyzed, with IE cases identified using the Modified Duke Criteria and matched to controls (1:3 ratio).
  • Multivariate logistic regression analyses were employed to determine risk factors.

Main Results:

  • Out of 520 patients with GBS bacteremia, 28 (5.4%) had IE (19 definite IE).
  • In-hospital mortality for GBS IE was 29% (8/28), and 29% (8/28) underwent surgery.
  • Significant risk factors for IE included injection drug use (OR=19.6), prosthetic valve (OR=11.5), and an unidentified source of bacteremia (OR=3.81).

Conclusions:

  • GBS bacteremia warrants increased clinical suspicion for IE, particularly in patients with specific risk factors.
  • Individuals who inject drugs, those with prosthetic valves, and patients with an unknown source of GBS bacteremia are at higher risk for developing IE.