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Inflammation of endocardium
A. Non-Infective
èRheumatic Endocarditis
èAtypical Verrucous Endocarditis
èNon bacterial thrombotic Endocarditis
B. Infective
èBacterial endocarditis
èOther Infective types (tuberculosis, syphilitic, fungal, viral, rickettsial)
INFECTIVE ENDOCARDITIS
BACTERIAL ENDOCARITIS
ETIOLOGY
a). The circulating bacteria are lodged much more frequently on previously damaged
valves from disease, chiefly RHD nad CHD than healthy valves
b). Conditions producing haemodynamic stress on the valves are liable to cause damage
to the endocardium, favouring the formation platelets thrombi which gets infected from
circulating bacteria
PATHOLOGIC CHANGES
MACROSCOPICALLY MICROSCOPICALLY
Lesions are in mitral>aortic>both > The out layer consists of
right heart eosinophilic material composed of
SABE > ABE fibrin platelets
Underneath layer is the basophilic
zone containing colonies of bacteria
The deeper zone consists of non-
specific inflammatory reaction
SYMPTOMS
Acute Subacute
High grade fever and chills Low grade fever
Arthralgias/ myalgias Anorexia
Abdominal pain Weight loss
Pleuritic chest pain Fatigue
Back pain Arthralgias/ myalgias
Abdominal pain
SIGNS
Fever
Heart murmur
Nonspecific signs –
1). Petechiae :- Often located on extremities or mucous membranes
2). subungal or “splinter” hemorrhages:- Nonblanching, Linear reddish-
brown lesions found under the nail bed, Usually do NOT extend the entire length of the
nail
3). clubbing,
4). splenomegaly,
5). neurologic changes
COMPLICATIONS