Complication and Treatment of Infectious Endocarditis
IE can be a lethal disease. Over the last decades, the incidence of disease has not decreased due to the change of risk conditions. Complications of IE may involve cardiac structures when the infection spreads within the heart or extra cardiac ones when the cause is usually from embolic origin. In most of the patients, there are a variety of problems. The literature reports one complication of IE in 57%, two in 26% and three or more in about 14% of patients examined. The infecting pathogen, duration of disease before therapy, and type of treatment are some of the variables that affect the occurrence of specific complications. It is difficult to assess the true incidence of complications because the published reviews are based on retrospective chart reviews and different diagnostic criteria are used. The decision over either indication or timing of surgery should be individualized and based on at least cardiologists and cardiac surgeons. The most important cause of IE is Congestive heart failure. Periannular abscesses are a relatively common complication of IE (42% to 85% of cases during surgery or at autopsy respectively), associated with a higher morbidity and mortality. Embolization can affect the central nervous system, but also other organs. Due to direct seeding of the spleen by an embolus or a bland infarction, there is a rare complication of IE. Neurological complications develop in 20% to 40% of patients with IE and represent a dangerous subset of complications.
Deepak Kumar*, Naveen Kumar Bathula
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