Why does splenomegaly occur in infective endocarditis?
Splenomegaly occurs in 37% of patients with active infective endocarditis and in 64% of those with pros- thetic valve endocarditis (10). It is most often due to congestion, hyperplasia, and infarction (11). At present, the actual incidence of splenic abscess in endocarditis is unknown.
How does infective endocarditis cause splenic abscess?
Splenic abscess develops because of bacteremic seeding of an infarcted splenic zone secondary to embolized vegetations, or more directly through seeding of the spleen by infected embolized heart valve vegetations [1]. Splenic abscess can be a rare complication of infective endocarditis [2].
What are the clinical manifestations of infective endocarditis?
Common signs and symptoms of endocarditis include:
- Aching joints and muscles.
- Chest pain when you breathe.
- Fatigue.
- Flu-like symptoms, such as fever and chills.
- Night sweats.
- Shortness of breath.
- Swelling in your feet, legs or abdomen.
How does hepatitis cause splenomegaly?
Liver disease (cirrhosis, hepatitis): Parenchymal liver disease causes increased vascular pressure leading to an increase in spleen size. Hematologic malignancies (lymphomas, leukemias, myeloproliferative disorders): Neoplastic cells cause infiltration of the spleen leading to splenomegaly.
Why does CHF cause splenomegaly?
Background: During the progression of chronic heart failure (CHF), decreased cardiac functioning is often associated with congestion in the inferior vena vein, which in turn induces splenomegaly and subsequent hypersplenism.
What causes splenic abscess?
Splenic abscesses are most regularly seen as complications of infective endocarditis, which occurs in about 5% of patients. Frequently, isolated pathogens include Streptococcus, Staphylococcus, (due to endocarditis being the most common cause of splenic abscess), Mycobacterium, fungi, and parasites.
Does endocarditis cause aortic stenosis?
Endocarditis frequently develops on a pathological valve. In the western world, the most common valve involvement is aortic sclerosis, that is, a certain degree of stenosis from age-associated valve degeneration.
What three critical elements are required for the pathogenesis of infective endocarditis?
The pathophysiology of infective endocarditis comprises at least three critical elements: preparation of the cardiac valve for bacterial adherence, adhesion of circulating bacteria to the prepared valvular surface, and survival of the adherent bacteria on the surface, with propagation of the infected vegetation.
What are some complications of infective endocarditis?
Complications of infective endocarditis (IE) include cardiac, metastatic, neurologic, renal, musculoskeletal, and pulmonary complications as well as complications related to systemic infection (including embolization, metastatic infection, and mycotic aneurysm). More than one complication can occur simultaneously.
Why are septic emboli a common complication of infective endocarditis?
Infective endocarditis is an established common cause of septic emboli from case studies as early as 1883. [3] Parts of the vegetations on the valves infected dislodge and travel through the bloodstream and block blood vessels based on the size and the location.
How is ultrasound used to diagnose splenomegaly?
Ultrasound is portable and does not involve ionis- ing radiation. It will confirm the presence of splenomegaly, distinguish focal lesions from diffuse enlargement, and can support a diagnosis of congestive splenomegaly. CT is more reproducible, and evaluates other organs where a systemic disorder is suspected.
What is the prognosis for infective endocarditis?
Treatment and prognosis. Infective endocarditis is a disease with a high morbidity and mortality, even with appropriate diagnosis and therapy 3. With treatment, which includes antibiotics and surgery, the mean in-hospital mortality of infective endocarditis is 15-20% with a 1-year mortality approaching 40% 1.
Which is the primary imaging modality of infective endocarditis?
Echocardiography is the primary imaging modality of cardiac infections. It has been integrated into the modified Duke criteria for diagnosis of infective endocarditis. An endocarditic vegetation is usually echogenic or isoechoic to muscle on echocardiography.
How is CT angiography used to diagnose endocarditis?
Cardiac CT angiography may demonstrate endocarditic vegetations as hypoattenuating filling defects surrounded by intravenous contrast material. Cardiac-gated CT angiography can also demonstrate valve tissue destruction, and perivalvular extension with pseudoaneurysm or fistula formation. CT may miss small vegetations.