Endocarditis
Valeria Fabre, M.D.
PATHOGENS
PATHOGENS
PATHOGENS
- Worldwide, staphylococci (S. aureus > CoNS) are the most common cause, followed by streptococci (Viridans group > S. bovis) and enterococci.
- Culture-negative endocarditis, ~10%.
- Native valve infective endocarditis (IE):
Native Valve Endocarditis Pathogens (see individual pathogens)Pathogen | Frequency |
S. aureus | 32% |
Viridans streptococci | 18% |
Enterococcus | 11% |
Coagulase-negative staphylococcus | 11% |
Streptococcus bovis | 7% |
Streptococcus (other) | 5% |
HACEK organisms [Haemophilus parainfluenzae, Aggregatibacter (formerly Haemophilus aphrophilus), Actinobacillus actinomycetemcomitans,
Cardiobacterium hominis, Eikenella corrodens, Kingella kingii] | 2% |
Gram-negative bacilli | 2% |
Fungi [Candida species, Aspergillus species (note: blood cultures rarely positive for Aspergillus)] | 2% |
Culture negative [consider HACEK organisms, nutritionally deficient Streptococcus species (e.g., Abiotrophia), Coxiella burnetii (Q fever),
Chlamydia psittaci, Mycoplasma spp., Legionella pneumophila, Bartonella species, Brucella species, Tropheryma whipplei] | 8% |
Prosthetic valve: approximate percentile presentationsPathogen | Early | Late |
CoNS | 28% | 20% |
S. aureus | 19% | 18% |
Strep species | 3% | 16% |
Enterococcus | 6% | 17% |
HACEK | 18% | 7% |
Fungi | 9% | 6% |
Polymicrobial | 6% | 2% |
Other | 6% | 6% |
Culture-negative | 3% | 4% |
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