Acute bacterial endocarditis following burns: case report and review.

Acute bacterial endocarditis (ABE) is a rare but deadly complication following major thermal injury. Typically the presentation is silent, with persistent fever and positive blood cultures being the only consistent findings. Fibrin-platelet vegetations on the valvular endocardium are thought to be seeded during bacteremic episodes. Manipulation of the burn wound is probably the most likely source of bacteremia, with Staphylococcus aureus and Gram-negative bacilli being the most commonly implicated bacteria. In addition to causing local damage to a valve or the myocardium, infected vegetations may dislodge septic emboli systemically. Diagnosis is most easily obtained by echocardiography. Treatment usually involves prolonged administration of intravenous antibiotics. In rare circumstances, valvular resection and replacement may be indicated.