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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 IV: Nursing Management01:29

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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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Endocarditis III: Medical Management01:18

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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 II: Clinical Features of Infective Endocarditis01:25

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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...
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Myocarditis III: Medical Management01:14

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Myocarditis: Comprehensive Medical ManagementMyocarditis, the heart muscle inflammation, requires a comprehensive medical management strategy that addresses the underlying cause, provides supportive care, manages symptoms, and reduces cardiac workload.Infections and Autoimmune CausesAdminister appropriate antimicrobial therapy when an infectious agent causes myocarditis. For instance, penicillin treats infections caused by Group A Streptococcus. In cases where autoimmune processes are...
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Myocarditis is inflammation of the myocardium, which is the muscular layer of the heart.EtiologyMyocarditis has a diverse etiology, including a wide range of infectious and non-infectious causes:Infectious CausesViral: Common viruses include Coxsackie A and B, adenovirus, parvovirus B19, enteroviruses, and influenza A.Bacterial: Examples include infections caused by Streptococcus, Staphylococcus, and Mycoplasma species.Rickettsial: Infections like Rocky Mountain spotted fever can result in...
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Infective endocarditis meets native vertebral osteomyelitis: a mortality perspective.

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Native vertebral osteomyelitis and infective endocarditis (NVO + IE) have high mortality rates, particularly with Staphylococcus aureus infections. Early diagnosis and multidisciplinary management are crucial for improving outcomes in these complex cases.

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Area of Science:

  • Infectious Diseases
  • Cardiology
  • Orthopedic Surgery

Background:

  • Native vertebral osteomyelitis (NVO) and infective endocarditis (IE) are increasingly recognized as overlapping conditions.
  • Common risk factors include advanced age, immunosuppression, and similar pathogens like Staphylococcus aureus and streptococci.
  • Concurrent NVO + IE presents diagnostic and therapeutic challenges, impacting clinical outcomes and mortality.

Purpose of the Study:

  • To systematically evaluate the combined mortality associated with concomitant NVO + IE.
  • To summarize the clinical characteristics of patients with NVO + IE from published studies.

Main Methods:

  • Systematic review following the PRISMA framework, searching MEDLINE, Embase, Cochrane Library, and Scopus (1970-October 2023).
  • Inclusion criteria: studies with at least 10 adult patients diagnosed with NVO and IE, providing mortality data.
  • Random-effects meta-analysis to aggregate in-hospital, 1-month, 1-year, and 3-year mortality rates.

Main Results:

  • 16 studies involving 641 patients with NVO + IE were included.
  • In-hospital mortality was 14.0%, 1-month mortality was 9.0%, 1-year mortality was 18.0%, and 3-year mortality was 16.0%.
  • Staphylococcus aureus predominance was associated with significantly higher 1-month mortality compared to streptococci. Certainty of estimates was low.

Conclusions:

  • Concomitant NVO + IE is associated with substantial mortality, particularly with S. aureus infections.
  • Highlights the need for earlier diagnosis, coordinated multidisciplinary management, and standardized treatment protocols.
  • Calls for future prospective, high-quality studies to clarify optimal diagnostic and surgical strategies.