Page 141 - Clinical Pearls in Cardiology

Chapt er
7 Heart Disease and Fever

1. What are the commonest diseases affecting the heart
that can cause fever ?
Diseases affecting the heart can produce fever in
some cases. The common diseases affecting the heart
associated with fever are the following:
• Infective endocarditis
• Rheumatic fever
• Atrial myxoma (rare).
2. Which are the commonest organisms causing infective
endocarditis?
The viridans group of streptococci (Strep. mitis, Strep.
sanguis, etc.) are commensals in the upper respiratory
tract. They are the commonest cause of subacute
endocarditis. Staphylococcus aureus is the commonest
cause of acute endocarditis (originating from skin
infections, abscesses, vascular access sites and in
intravenous drug abusers). The most common organism
causing postoperative endocarditis after cardiac
surgery is a coagulase negative Staphylococcus called as
S. epidermidis.
3. What is meant by culture negative endocarditis ?
Blood culture negative infective endocarditis (BCNIE)
occurs in 2.5–31% of all cases of endocarditis. The
commonest causes for BCNIE are the following:
1. Prior use of antibiotics