Diagnosis, management, and prevention of infective endocarditis.

The epidemiologic, clinical, and microbiologic patterns of infective endocarditis have been undergoing constant change. Prompt diagnosis of infective endocarditis requires clinical suspicion in proper clinical settings and appropriate laboratory tests. Once the infecting organism is identified in blood cultures, the majority of patients with infective endocarditis can be cured by prolonged, intensive antimicrobial therapy. Surgical intervention may be needed in certain patients. Infective endocarditis may be prevented in some patients by the elimination of predisposing factors. Patients with underlying heart diseases should receive antimicrobial prophylaxis immediately before undergoing surgical procedures that are associated with significant risks of bacteremia.