Update on infectious endocarditis

Although one of the oldest known cardiac disease, infectious endocarditis (IE) remains a subject of constant change from epidemiological, diagnostic and therapeutic points of view. In the epidemiological field, the main feature is the increasing incidence of IE due to streptococcus bovis. Representing a quarter of cases in France, this type of IE is particularly frequent in the elderly and underlying colonic disease should be investigated. In the diagnostic field, the progress of methods of microbiological identification has been considerable, especially in molecular (PCR) and histological diagnosis which are particularly useful in IE with negative blood cultures. From the prognostic point of view, the role of echocardiography has recently been emphasised riot only for diagnosis but also for prognosis and for predicting the embolic risk. The longest vegetations (> 10 or 15 mm) are associated with a greater risk not only of embolism but also in terms of prognosis. The recent recommendations of the French Society of Cardiology recall the main surgical indications in IE and include a new indication of echocardiography.