Infective endocarditis

Etiology

Native valve (non-IVDU)

  • Viridans streptococci (60%)
  • Staphylococcus aureus (20%)
  • Enterococci (5-10%)
  • Less common:
    • Other streptococci, eg, Streptococcus pneumoniae; group A Streptococcus; groups B, C, and G streptococci
    • HACEK organisms (gram-negative): Haemophilus aphrophilus, Haemophilus parainfluenzae, Actinobacillus actinomycetemcomitans, Cardiobacterium hominis, Eikenella corrodens, Kingella kingae
    • Fungi

IVDU with native valve

  • Staphylococcus aureus (60%)
  • Enterococci
  • Streptococci
  • Gram-negative rods, eg, Pseudomonas, Serratia
  • Fungi, eg, Candida

Prosthetic valve

  • Early (< 2 months): Staphylococcus aureus, coagulase-negative Staphylococcus, gram-negatives, fungi
  • Late (>2 months): Like native valve plus coagulase-negative Staphylococcus

"Culture negative" endocarditis

  • Fungi
  • Q fever
  • Legionella
  • Psittacosis
  • Bartonella
  • Nutritionally deficient streptococci
  • Brucella
  • HACEK organisms
  • Anaerobes

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Last updated: January 13, 2015