Complications of Infective endocarditis (Robbins pp 574)

Cardiac: 1) valvular incompetence / stenosis (obstruction from vegetations) ≫ cardiac failure, 2) myocardial ring abscess, with perforation of IV septum, aortic wall, conduction system, 3) suppurative pericarditis, 4) endocarditis on artificial valves can split open valves ≫ paravalvular leak.

Embolic: 1) brain – cerebral infarct, meningitis, abscess, 2) heart (MI), 3) spleen (abscess), 4) kidneys (abscess)

Immune complex generation: deposits in walls of vessels ≫ inflammatory reaction ≫ Osler’s nodes (painful), skin infarcts, Roth spots: fundal vasculitic lesions, Janeway lesions, splinter haemorrhages. Can also deposit in renal glomeruli (i.e.: these are vessels too) cause basement membrane damage ≫ ↓ GFR ≫ renal failure.

Category: Pathology Notes