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Unexpected Infective Endocarditis: Towards a New Alert for Clinicians.

Giovanni La Canna1, Lucia Torracca2, Alessandro Barbone2

  • 1Applied Diagnostic Echocardiography, IRCCS Humanitas Clinical and Research Hospital, 20089 Rozzano, Milan, Italy.

Journal of Clinical Medicine
|September 14, 2024
PubMed
Summary

Infective Endocarditis (IE) diagnosis is challenging due to evolving patient profiles and atypical presentations. Increased vigilance for unexpected IE cases in emergent at-risk populations is crucial for timely treatment.

Keywords:
emergent at-risk populationinfective endocarditissubtle clinical phenotypesunexpected diagnostic challenges

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Area of Science:

  • Cardiology
  • Infectious Diseases
  • Internal Medicine

Background:

  • Infective Endocarditis (IE) recognition remains challenging despite established guidelines.
  • Epidemiological and clinical profiles of IE are shifting, with increased incidence in non-traditional at-risk groups.
  • Immunocompromised individuals and even healthy subjects with specific exposures are emerging as at-risk populations.

Purpose of the Study:

  • To analyze the subtle and deceptive clinical phenotypes of unexpected Infective Endocarditis.
  • To highlight the challenges in diagnosing IE due to evolving patient demographics and presentations.
  • To emphasize the need for increased clinical awareness and preventive measures in emergent at-risk populations.

Main Methods:

  • Review of clinical cases presenting with subtle and deceptive phenotypes of Infective Endocarditis.
  • Analysis of changes in epidemiological and clinical profiles of IE.
  • Evaluation of emergent at-risk populations and their unique exposure pathways.

Main Results:

  • IE presentation is evolving, moving beyond the conventional paradigm.
  • Atypical IE presentations can occur in immunocompromised patients and healthy individuals with specific exposures (e.g., skin contact, implants).
  • The unusual clinical context of emergent IE cases may lead to delayed diagnosis and treatment.

Conclusions:

  • Clinicians must be aware of unexpected IE clinical courses and consider diagnosis in patients with atypical features.
  • Enhanced vigilance is necessary for preventive strategies targeting emergent at-risk populations.
  • Recognizing subtle IE phenotypes is critical for improving patient outcomes.