Acute infective endocarditis

Acute infective endocarditis (AIE) is often part of severe systemic infection, with highly virulent pathogenic microorganisms such as Staphylococcus aureus (the most common, accounting for more than 50%), hemolytic streptococci, meningococci, and Escherichia coli. Clinically, it is less common than subacute infective endocarditis, and patients usually have no history of heart disease. Acute infective endocarditis is often part of severe systemic infection. The onset is acute and progression is rapid. Sixty percent of patients have no pre-existing cardiac disease. The causative organisms are highly virulent, with Staphylococcus aureus accounting for more than 50%; hemolytic streptococci, pneumococci, Gram-negative bacilli, and fungi can also cause the disease. Septicemia is the main clinical manifestation, including high fever, chills, tachycardia, tachypnea, muscle and joint pain, altered consciousness, skin petechiae, embolism of various organs, highly variable heart murmurs, markedly elevated leukocyte count, progressive anemia, and positive blood cultures. Because the systemic infection symptoms are severe, they may mask the clinical manifestations of acute infective endocarditis. Without timely effective antibiotic treatment, the mortality rate is very high.