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

ESC Clinical Practice Guidelines

Cardiovascular Surgery
Infective Endocarditis
Valvular Heart Disease
Device Complications and Lead Extraction
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
Published in 2015
Reference ESC Pocket Guidelines App
Published in 2016
Reference Web Document
Published in 2016
Reference IE
Published in 2016
Reference Key messages and Gaps in evidence
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. Appendix
15. References


Previous version available to download
Published in 2009
Reference European Heart Journal (2009) 30, 2369–2413; doi:10.1093/eurheartj/ehp285