Synopsis
1. Introduction.- 1.1. Terminology.- Reference.- 2. The Pathogenesis of Intravascular Infection.- 3. The Nonbacterial Thrombotic Vegetation.- 3.1. Endothelial Damage.- 3.2. Hypercoagulability.- 3.3. Cancer.- 3.4. Infection.- 3.5. Immune Complexes.- 3.6. Limitation of Growth of Vegetations.- 3.6.1. Embolization.- 3.6.2. Fibrinolysis, Organization, and Endothelialization.- 3.7. Fibroblastic Parietal Endocarditis with Eosinophilia (Löffler's Endocarditis).- 3.8. Arteriosclerosis.- 3.9. Nonbacterial Thrombotic Vegetation in the Venous System.- References.- 4. Establishment of Intravascular Infection.- 4.1. Bacteremia-The Capacity to Induce Infection.- 4.2. Types and Source of Bacteria Responsible for Intravascular Infection.- 4.2.1. Infective Endocarditis.- 4.2.2. Mycotic Aneurysm.- 4.2.3. Vascular-Graft Infections.- 4.3. Susceptibility of Nonbacterial Thrombotic Vegetation to Infection.- 4.3.1. Size of Nonbacterial Thrombotic Vegetation.- 4.3.2. Localization and Frequency within the Vascular System.- 4.3.3. Pathology of Thrombotic Vegetation.- References.- 5. Prophylaxis of Intravascular Infection.- 5.1. Infective Endocarditis.- 5.1.1. Anticoagulants.- 5.1.2. Bacterial Sticking.- 5.1.3. Microorganisms.- 5.1.4. Choice of Antibiotics.- 5.1.5. Choice of Subjects.- 5.2. Prosthetic-Valve Surgery.- 5.3. Vascular Grafts.- References.- 6. Consequences of Intravascular Infection.- 6.1. Establishing the Diagnosis.- 6.1.1. Clinical Presentation of Infective Endocarditis.- 6.1.2. Mycotic Aneurysm (Primary).- 6.1.3. Infection in Peripheral Veins.- 6.1.4. Clinical Diagnosis.- 6.2. Prolonged Bacteremia.- 6.2.1. Blood Culture.- 6.2.2. Fever and Constitutional Symptoms.- 6.2.3. Hematological Findings.- 6.2.4. Splenomegaly.- 6.2.5. Metastatic Infection.- 6.3. Host Responses to Bacteremia.- 6.3.1. Intravascular Coagulation.- 6.3.2. Anticoagulants.- 6.3.3. Specific Circulating Antibody.- 6.3.4. Circulating Immune Complexes.- 6.4. Local Invasion.- 6.4.1. Valve Destruction.- 6.4.2. Congestive Heart Failure.- 6.4.3. Valve-Ring Abscess.- 6.4.4. Valve Obstruction.- 6.5. Peripheral Emboli.- 6.5.1. Nervous System.- 6.5.2. Spleen, Gallbladder, and Liver.- 6.5.3. Kidney.- 6.5.4. Bone.- 6.5.5. Major Arteries.- 6.5.6. Mycotic Aneurysms.- 6.5.7. Heart.- 6.6. Mortality and Factors Affecting Prognosis.- References.- 7. Host Defense Mechanisms.- 7.1. Location within the Vascular System.- 7.2. Polymorphonuclear Leukocytes.- 7.3. Healing-Endothelialization.- 7.4. Role of Foreign Body.- 7.5. Aging of Bacteria.- 7.6. Serum Bactericidal Activity.- References.- 8. Treatment.- 8.1. Decision to Treat.- 8.2. Negative Blood Cultures.- 8.3. Positive Blood Cultures.- 8.4. Antibiotics.- 8.4.1. Principles.- 8.4.2. Recommended Treatment Programs.- 8.5. Special Problems of Microbial Infection.- 8.5.1. Gram-Negative Bacilli.- 8.5.2. Gram-Positive Bacilli ("Diphtheroids").- 8.5.3. Anaerobic Bacteria.- 8.5.4. Chlamydiae.- 8.5.5. Mycobacteria.- 8.5.6. Q Fever.- 8.5.7. Viruses.- 8.5.8. Fungi.- 8.5.9. Pneumococci.- 8.5.10. Neisseria Species.- 8.5.11. Staphylococcus epidermidis, Coagulase-Negative Staphylococci, and Micrococci Species.- 8.5.12. Streptococci.- 8.6. Surgery.- 8.6.1. Valve Destruction-Congestive Heart Failure.- 8.6.2. Antibiotic Failure.- 8.6.3. Peripheral Embolization.- 8.6.4. Cardiac Conduction Abnormalities.- 8.6.5. Peripheral Arterial Grafts.- 8.6.6. Purulent Thrombophlebitis.- 8.6.7. Cardiac Catheterization and Endocardial Pacemakers.- 8.6.8. Miscellaneous.- 8.7. Treatment of Septic Arthritis and Osteomyelitis.- 8.8. Treatment of Glomerulonephritis.- 8.9. Special Aspects of Patient Care.- References.- 9. Indices of Effectiveness of Treatment.- 9.1. Clinical.- 9.2. Laboratory.- 9.2.1. Serum Bactericidal Activity.- 9.2.2. Other Studies.- 9.3. Bacteriology of Surgically Removed Vegetations.- References.- 10. Outcome of Treatment.- 10.1. Medical.- 10.2. Surgical.- References.- 11. Complications of Treatment.- Appendix. AHA Committee Report: Prevention of Bacterial Endoc
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