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Old 04-23-2011
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Heart Kaplan Lecture Notes Conflicting Info about Infective Endocarditis!

I have a question, since the Kaplan IM 2008-2009 book on this is confusing.

First it says:

Microorganisms responsible for Infective Endocarditis:
Native valves:
Strep viridans 50-60%
Enterococci 5-15
Other streptococci 15-20
S aureus 20-30
S epidermidis 1-3
In Narcotics addicts
S aureus 60-95
S epidermidis 5-10

Prosthetic Valves
S epidermidis 40-50
S viridans 5-20
S aureus 15-20



So by this logic, in NORMAL valves, the commonest cause of IE is viridans in non-IVDU and aureus in IVDU, and with ABNORMAL valves, the commonest is epidermidis.


However, later on the same page (221-222), it says:

Acute Infective Endocarditis
S aureus most common cause of acute endocarditis
previousliy normal valves
IVDU major risk factor

Subacute Infective Endocarditis
Viridans streptococci is most common organism
seed previously abnormal valves


So this is completely going against what it said in the table directly above - normal valves - S aureus (NOT viridans) and abnormal valves - viridans (NOT epidermidis)???

Can anyone explain and perhaps just tell me exactly what I should be thinking for my exam?
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Old 04-23-2011
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i dont we have to confuse ourselves too much.

if the case says acutely developed valve endocarditis, think s.aureus. if IVDU think s.aureus. in a normal person who slowly develops symptoms think viridans.... i think its hard to describe a sub-acute case.
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Old 04-23-2011
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Just follow this
Infective Endocarditis: Most common infective microorganisms
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