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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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The hosts' susceptibility to infection depends on several factors. The integrity of the skin and mucous membranes helps protect the body against microbial attacks. When the skin is altered, the chance of infection, limb loss, and even death increases.
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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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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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Related Experiment Video

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Baseline Antithrombotic Therapy and Intracranial Hemorrhage Risk in Infective Endocarditis: A Multicenter Prospective

Javier T Solera1, Eduardo Aparicio-Minguijón1, Laura Domínguez-Pérez2

  • 1Unit of Infectious Diseases, Hospital Universitario 12 de Octubre, Instituto de Investigación Biomédica imas12, Madrid, Spain.

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|February 5, 2026
PubMed
Summary

Antithrombotic therapy, particularly anticoagulation, increases intracranial hemorrhage risk in infective endocarditis (IE). Baseline antithrombotic use aids early neurologic risk stratification for IE patients.

Keywords:
Antithrombotic TherapyInfective EndocarditisIntracranial HemorrhageIschemic StrokeMortality

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Area of Science:

  • Neurology
  • Cardiology
  • Infectious Diseases

Background:

  • Infective endocarditis (IE) poses significant risks, primarily due to neurological complications.
  • The role of chronic antithrombotic therapy in IE patients with neurological complications is not well-defined.

Purpose of the Study:

  • To investigate the association between baseline antithrombotic therapy and intracranial hemorrhage (ICH) and mortality in patients with left-sided IE.

Main Methods:

  • A prospective multicenter cohort study analyzed 3,236 patients with definite left-sided IE from 2008-2018.
  • Patients were categorized into no therapy (NT), antiplatelet therapy (APT), anticoagulation (AC), or combined therapy (CAT) groups.
  • Outcomes included 30-day ICH, ischemic stroke, embolic events, major bleeding, and all-cause mortality, analyzed using multivariable regression models.

Main Results:

  • ICH occurred in 5.6% of patients, with higher incidence in CAT (9.5%) and AC (6.8%) groups compared to NT.
  • Baseline AC independently increased ICH risk (aRR 1.83), with CAT showing the highest risk (aRR 2.45).
  • Combined therapy (CAT) predicted higher 1-year mortality (aHR 1.21), while APT showed no association with ICH.

Conclusions:

  • Baseline antithrombotic therapy, particularly anticoagulation, is a significant factor in predicting ICH in IE.
  • Microbiologic etiology, prior cerebrovascular disease, and antithrombotic use are crucial for early neurologic risk stratification in IE.
  • Findings support informed neuroimaging decisions and multidisciplinary care for IE patients.