Endocarditis

Valeria Fabre, M.D.

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 presentations

Pathogen

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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Last updated: May 17, 2024