ISSN 2398-2969      

Endocarditis: bacterial

icanis

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.

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