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Infective Endocarditis (Guidelines on Prevention, Diagnosis and Treatment of)

ESC Clinical Practice Guidelines

Infective Endocarditis
Cardiovascular Surgery
Valvular Heart Diseases
Guidelines version available to download
Published in 2015
Reference European Heart Journal, doi/10.1093/eurheartj/ehv319
Published in 2015
Reference 36 CME Questions - Infective Endocarditis
Published in 2015
Reference Infective Endocarditis Pocket Guidelines
  • PDA
  • Published in 2015
    Reference ESC Pocket Guidelines App
    Published in
    Reference Key messages and Gaps in evidence
    Published in 2009
    Reference European Heart Journal (2009) 30, 2369–2413; doi:10.1093/eurheartj/ehp285

    Gilbert Habib (Chairperson) (France), Patrizio Lancellotti (co-Chairperson) (Belgium), Manuel J. Antunes (Portugal), Maria Grazia Bongiorni (Italy), Jean-Paul Casalta (France), Francesco Del Zotti (Italy), Raluca Dulgheru (Belgium), Gebrine El Khoury (Belgium), Paola Anna Erbaa (Italy), Bernard Iung (France), Jose M. Mirob (Spain), Barbara J. Mulder (The Netherlands), Edyta Plonska-Gosciniak (Poland), Susanna Price (UK), Jolien Roos-Hesselink (The Netherlands), Ulrika Snygg-Martin (Sweden), Franck Thuny (France), Pilar Tornos Mas (Spain), Isidre Vilacosta (Spain), and Jose Luis Zamorano (Spain)

    Endorsed by cardiac societies
    Table of contents: Full Text (ESC Clinical Practice Guidelines)

    Table of contents: Full Text (ESC Clinical Practice Guidelines)

    1. Preamble
    2. Justification/scope of the problem
    3. Prevention
    3.1 Rationale
    3.2 Population at risk
    3.3 Situations and procedures at risk
    3.3.1 Dental procedures
    3.3.2 Other at-risk procedures
    3.4 Prophylaxis for dental procedures
    3.5 Prophylaxis for non-dental procedures
    3.5.1 Respiratory tract procedures
    3.5.2 Gastrointestinal or genitourinary procedures
    3.5.3 Dermatological or musculoskeletal procedures
    3.5.4 Body piercing and tattooing
    3.5.5 Cardiac or vascular interventions
    3.5.6 Healthcare-associated infective endocarditis
    4. The ‘Endocarditis Team’
    5. Diagnosis
    5.1 Clinical features
    5.2 Laboratory findings
    5.3 Imaging techniques
    5.3.1 Echocardiography
    5.3.2 Multislice computed tomography
    5.3.3 Magnetic resonance imaging
    5.3.4 Nuclear imaging
    5.4 Microbiological diagnosis
    5.4.1 Blood culture–positive infective endocarditis
    5.4.2 Blood culture–negative infective endocarditis
    5.4.3 Histological diagnosis of infective endocarditis
    5.4.4 Proposed strategy for a microbiological diagnostic algorithm in suspected IE
    5.5 Diagnostic criteria
    6. Prognostic assessment at admission
    7. Antimicrobial therapy: principles and methods
    7.1 General principles
    7.2 Penicillin-susceptible oral streptococci and Streptococcus bovis group
    7.3 Penicillin-resistant oral streptococci and Streptococcus bovis group
    7.4 Streptococcus pneumoniae, beta-haemolytic streptococci (groups A, B, C, and G)
    7.5 Granulicatella and Abiotrophia (formerly nutritionally variant streptococci)
    7.6 Staphylococcus aureus and coagulase-negative staphylococci
    7.7 Methicillin-resistant and vancomycin-resistant staphylococci
    7.8 Enterococcus spp
    7.9 Gram-negative bacteria
    7.9.1 HACEK-related species
    7.9.2 Non-HACEK species
    7.10 Blood culture–negative infective endocarditis
    7.11 Fungi
    7.12 Empirical therapy
    7.13 Outpatient parenteral antibiotic therapy for infective endocarditis
    8. Main complications of left-sided valve infective endocarditis and their management
    8.1 Heart failure
    8.1.1 Heart failure in infective endocarditis
    8.1.2 Indications and timing of surgery in the presence of
    heart failure in infective endocarditis
    8.2 Uncontrolled infection
    8.2.1 Persisting infection
    8.2.2 Perivalvular extension in infective endocarditis
    8.2.3 Indications and timing of surgery in the presence of uncontrolled infection in infective endocarditis
    8.3 Prevention of systemic embolism
    8.3.1 Embolic events in infective endocarditis
    8.3.2 Predicting the risk of embolism
    8.3.3 Indications and timing of surgery to prevent embolism in infective endocarditis
    9. Other complications of infective endocarditis
    9.1 Neurological complications
    9.2 Infectious aneurysms
    9.3 Splenic complications
    9.4 Myocarditis and pericarditis
    9.5 Heart rhythm and conduction disturbances
    9.6 Musculoskeletal manifestations
    9.7 Acute renal failure
    10. Surgical therapy: principles and methods
    10.1 Operative risk assessment
    10.2 Preoperative and perioperative management
    10.2.1 Coronary angiography
    10.2.2 Extracardiac infection
    10.2.3 Intraoperative echocardiography
    10.3 Surgical approach and techniques
    10.4 Postoperative complications
    11. Outcome after discharge: follow-up and long-term prognosis
    11.1 Recurrences: relapses and reinfections
    11.2 Short-term follow-up
    11.3 Long-term prognosis
    12. Management of specific situations
    12.1 Prosthetic valve endocarditis
    12.1.1 Definition and pathophysiology
    12.1.2 Diagnosis
    12.1.3 Prognosis and treatment
    12.2 Infective endocarditis affecting cardiac implantable electronic devices
    12.2.1 Introduction
    12.2.2 Definitions of cardiac device infections
    12.2.3 Pathophysiology
    12.2.4 Risk factors
    12.2.5 Microbiology
    12.2.6 Diagnosis
    12.2.7 Treatment
    12.2.8 Antimicrobial therapy
    12.2.9 Complete hardware removal (device and lead extraction)
    12.2.10 Reimplantation
    12.2.11 Prophylaxis
    12.3 Infective endocarditis in the intensive care unit
    12.3.1 Organisms
    12.3.2 Diagnosis
    12.3.3 Management
    12.4 Right-sided infective endocarditis
    12.5 Infective endocarditis in congenital heart disease
    12.6 Infective endocarditis during pregnancy
    12.7 Antithrombotic therapy in infective endocarditis
    12.8 Non-bacterial thrombotic endocarditis and endocarditis associated with cancers
    12.8.2 Infective endocarditis associated with cancer
    13. To do and not to do messages from the guidelines
    14. Apendix
    15. References





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