Educational resource · Not a medical device · Infectious diseases review in progress · Does not replace clinical judgement

Diagram — Infective endocarditis — SeptiMap

explain how a vegetation forms, where emboli come from, and why diagnosis combines repeated blood cultures and echocardiography. Educational resource, not a medical device.

Diagrams: mechanisms and principles

17 sourced diagrams · for medical students and practice

Each diagram reads step by step: an objective, the steps, three key points, a classic pitfall, its sources and the related atlas pages. Revision mode hides the labels to test yourself.

Clinical years · OSCE

Infective endocarditis

Objective: explain how a vegetation forms, where emboli come from, and why diagnosis combines repeated blood cultures and echocardiography.

Step 6 / 6
Infective endocarditis1. Endothelial damage — Turbulence, valve disease, devices or injections damage the endothelium: fibrin and platelets deposit (non-bacterial thrombotic endocarditis). 2. Infected vegetation — During bacteraemia, bacteria adhere to the damaged surface and become buried in a protective fibrin–platelet matrix. 3. Emboli — Vegetation fragments travel: systemic emboli to brain, spleen, kidneys. 4. Valve destruction — Leaflet perforation, rupture of chordae, septum or papillary muscle. 5. Blood cultures — Bacteraemia is usually continuous: most patients have positive blood cultures; negative blood cultures mainly after prior antibiotic therapy, or with intracellular agents (ESC 2023). 6. Diagnosis — Diagnosis combines clinical, microbiological and echocardiographic findings (modified Duke criteria); early echocardiography may be normal.DamagedendotheliumBacteraemiaVegetation: fibrin,platelets, bacteriaEmboliBrainSpleenKidneysPerforation,chordalruptureUsually continuous bacteraemia:blood cultures mostly positiveDiagnosis: clinical, microbiologyand echocardiography (modified Dukecriteria); early echo may be normal
  • Host (cells, tissues)
  • Pathogen
  • Structure
  • Toxin, damage
  • Clinical consequence

Key points

  • Endothelial damage, then fibrin and platelet deposits: the ground for a vegetation.
  • Bacteria become buried in this matrix; its fragments embolise.
  • Usually continuous bacteraemia: most patients have positive blood cultures; diagnosis by modified Duke criteria.

Classic pitfall

Believing a normal first echocardiogram rules out endocarditis: it may be negative early on.

Related pathogen pages (7)

Sources

Educational content · Illustrative mechanisms · Not applicable to individual clinical decisions · MDR 2017/745

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