INFECTIVE ENDOCARDITIS

The subject of infective endocarditis continues to attract the attenti on of many physicians. Optimal management of endocarditis requires int egrated input from experts in diverse specialties: infectious diseases , cardiology and echocardiography, surgery, neurology, microbiology, a nd pathology. Areas of active investigation include defining the vario us uses of echocardiography; elucidating natural history of endocardit is in patients at increased risk, especially drug abusers; conducting follow-up studies on patient survival; evaluating new treatment option s and prophylaxis; and defining the shifting spectrum of uncommon orga nisms that cause endocarditis. Decisions about the optimal timing of s urgery remain challenging. New therapeutic options, including home the rapy, are emerging. Although microbiologic cure can be achieved in mos t patients with endocarditis, the long-term prognosis remains surprisi ngly poor, and many patients require valve surgery.