INFECTIVE ENDOCARDITIS

The subject of infective endocarditis continues to attract the attention of many physicians. Optimal management of endocarditis requires integrated input from experts in diverse specialties: infectious diseases, cardiology and echocardiography, surgery, neurology, microbiology, and pathology. Areas of active investigation include defining the various uses of echocardiography; elucidating natural history of endocarditis in patients at increased risk, especially drug abusers; conducting follow-up studies on patient survival; evaluating new treatment options and prophylaxis; and defining the shifting spectrum of uncommon organisms that cause endocarditis. Decisions about the optimal timing of surgery remain challenging. New therapeutic options, including home therapy, are emerging. Although microbiologic cure can be achieved in most patients with endocarditis, the long-term prognosis remains surprisingly poor, and many patients require valve surgery.