Endocarditis etiology

Houpikian P, Raoult D. Blood culture-negative endocarditis in a reference center Etiologic diagnosis of 348 cases. Medicine 2005 84 162-173. 

Empiric treatment for subacute endocarditis likely to be caused by penicillin-sensitive streptococci consists of high dose penicillin G (6 x 3 million units i.v. daily) plus gentamicin (1x3 mg/kg). In acute endocarditis a staphylococcal etiology is more likely and, therefore, gentamicin is combined with (flu)cloxacillin (6 x 2 g i.v. daily). 

Answer Because of the patient s dental history, that is, an abscess and several carious teeth, and the presence of heart murmurs and low grade fever at night, the possibility of subacute bacterial endocarditis is likely. Streptococcus of the viridans group is a common etiological agent for this condition in patients with dental problems. 

Question A.14 Assuming that the patient is suffering from endocarditis due to Streptococci, what antibiotic would be appropriate to employ empirically before the etiological organism was identified ... 

Mycotic aneurysms from bacterial endocarditis were initially the most common cause of hepatic artery aneurysm [11]. However, traumatic and iatrogenic causes are likely the most common etiology today. Medial degeneration and atherosclerotic changes have also been implicated. However, atherosclerosis is more likely the result rather than the cause of the... 

The superior mesenteric artery aneurysm is the third most common VAA but only accounts for 6% of all splanchnic aneurysms. It is typically associated with an infectious etiology such as endocarditis. Thrombosis and dissection can be seen with these lesions and patients can present with symptoms of mesen-... 

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