Infective endocarditis

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Infective endocarditis (IE) is caused by invasion of the valvular endothelium by microbes, resulting in proliferative or erosive lesions and consequently valvular insufficiency. The mitral and aortic valves are almost exclusively infected in small animals. Vegetative lesions may result in embolism or metastatic infection involving multiple body organs, producing a large variety clinical signs. Endocarditis has a low incidence (0.04–0.13% of all dogs referred to one veterinary teaching hospital). The incidence in cats is considerably lower. Aetiology; Pathophysiology; Clinical signs; Diagnostic approach; Treatment; Monitoring and management; and Prognosis are all considered.

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Image of 22.1
22.1 Severe aortic valve endocarditis in a Boxer. (Courtesy of V. Luis Fuentes.) Histopathological examination of the aortic valve in a Kelpie showing infiltrates of inflammatory cells within the cusps. (Courtesy of G. Hestvik.) Echocardiogram performed during the clinical work up of the dog in (b) showing thickened and immobile aortic valve cusps and significant aortic regurgitation (arrowhead).
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22.3 Valvular vegetation of the mitral valve (arrowhead) in a Rhodesian Ridgeback with a newly discovered heart murmur. Multi-drug resistant was isolated from the blood culture. The dog was treated aggressively with antibiotics according to the resistance pattern for 3 months. After 3 months the vegetation had decreased in size considerably (arrowhead), but had not resolved completely.
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