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DEFINITIONS AND EPIDEMIOLOGY

Infective endocarditis (IE) denotes infection of the endocardial surface of the heart and implies the physical presence of microorganisms in the lesion. Although the heart valves are most commonly affected, the disease may also occur within the heart in the location of congenital septal defects or on the endocardial surface in areas of turbulent flow. Extracardiac infections of arteriovenous or arterioarterial shunts (patent ductus arteriosus), infection related to structural aortic arch anomalies, and infections of prosthetic materials such as vascular occluders and stents can also be included in this definition, due to similar clinical manifestations. Unfortunately, variability in the clinical presentation continues to make the diagnosis of IE clinically challenging. The Duke Criteria for the Diagnosis of Infective Endocarditis have been developed1 and modified.2 These criteria (listed in Tables 40-1 and 40-2) have been validated in multiple studies and have been shown to be superior to other criteria for the diagnosis of IE in the pediatric population.3–5

TABLE 40-1Definition of Infective Endocarditis According to Modified Duke Criteria
TABLE 40-2Definitions of Terms Used in Modified Duke Criteria for Diagnosis of Infective Endocarditis

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