Native-Valve Infective Endocarditis

This comprehensive clinical review discusses native-valve infective endocarditis (IE), emphasizing its evolving epidemiology, pathogenesis, and management. The article outlines diagnostic strategies using the modified Duke criteria, highlights key microbial causes—chiefly Staphylococcus aureus, Streptococcus spp., and Enterococcus faecalis—and stresses the importance of echocardiography, particularly transesophageal imaging. It evaluates optimal antimicrobial regimens, including beta-lactams for MSSA and ampicillin–ceftriaxone for enterococcal IE, especially in renal impairment. The review addresses challenges such as culture-negative cases, timing of surgical intervention, and use of oral step-down therapy in selected patients. Recommendations are grounded in current clinical guidelines and observational data, with emphasis on multidisciplinary care.

This comprehensive clinical review discusses native-valve infective endocarditis (IE), emphasizing its evolving epidemiology, pathogenesis, and management. The article outlines diagnostic strategies using the modified Duke criteria, highlights key microbial causes—chiefly Staphylococcus aureus, Streptococcus spp., and Enterococcus faecalis—and stresses the importance of echocardiography, particularly transesophageal imaging. It evaluates optimal antimicrobial regimens, including beta-lactams for MSSA and ampicillin–ceftriaxone for enterococcal IE, especially in renal impairment. The review addresses challenges such as culture-negative cases, timing of surgical intervention, and use of oral step-down therapy in selected patients. Recommendations are grounded in current clinical guidelines and observational data, with emphasis on multidisciplinary care.