Canis ISSN: 2398-2942
Endocarditis: bacterial
Contributor(s): Serena Brownlie, Mark Rishniw
Introduction
- Rare.
- Valvular (usually mitral and aortic valves). Less commonly mural.
- Cause: usually history of previous septic focus or febrile illness (but not always).
- Signs: episodic illness with pyrexia, multi-system involvement, and variable heart murmurs.
- Diagnosis: history, signs, ultrasonography.
- Treatment: antibiotic.
- Prognosis: guarded.
Pathogenesis
Etiology
Predisposing factors
General
- Previous infection/wound inappropriately treated.
- Non-aseptic surgical procedure.
- Immunosuppressive therapy (glucocorticoids).
- Long-term indwelling venous cannula.
- Aortic stenosis Heart: aortic stenosis (congenital).
Pathophysiology
- Bacterial infection → bacteremia → adherence to normal or abnormal valve and fibrin deposition over time → develops into a vegetation → bacteria can seed off intermittently → episodic pyrexia and variable clinical signs depending on terminus of septic embolism → destruction of valve → insufficiency or stenosis.
- Septic embolization usually causes signs other than cardiac dysfunction, eg septic arthritis Arthritis: septic , septic emboli in kidneys Kidney: thromboembolism.
- Septic embolization → valve vegetation → altered hemodynamics of the specific valve → valvular insufficiency → valvular stenosis → heart failure.
- Also, valvular vegetation → seed septic emboli to other organs → variable manifestations.
Timecourse
- Variable, eg 6-12 weeks after non-specific pyrexic illness.
Diagnosis
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Treatment
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Outcomes
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Further Reading
Publications
Refereed papers
- Recent references from PubMed and VetMedResource.
- Peddle G & Sleeper M M (2007) Canine bacterial endocarditis: a review. JAAHA 43 (5), 258-263 PubMed.
- Sykes J E, Kittleson M D, Pesavento P A, Bryne B A, MacDonald K A & Chomel B B (2006) Evaluation of the relationship between causative organisms and clinical characteristics of infective endocarditis in dogs: 71 cases (1992-2005). JAVMA 228 (11), 1723-1734 PubMed.
- Boswood A (1996) Resolution of dysrhythmias and conduction abnormalities following treatment for bacterial endocarditis in a dog. JSAP 37 (7), 327-332 PubMed.
- Bennett D, Taylor D J (1988) Bacterial infective arthritis in the dog. JSAP 29 (4), 207-230 VetMedResource.
- Ellison G W, King R R, Calderwood-Mays M (1988) Medical and surgical management of multiple organ infarts, secondary to bacterial endocarditis in a dog. JAVMA 193 (10), 1289-1291 PubMed.