View source for Bacterial Endocarditis (histological slide)

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<div style="margin:2px;">'''Overview'''</div>
<div> [[File:Bakteriální endokarditis(28A).jpg|Overview|400px]] </div>
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<div style="margin:2px;">'''Enlargement'''</div>
<div> [[File:Bakteriální endokarditis(28B).jpg|Enlargement|400px]] </div>
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<div style="margin:2px;">'''Detail'''</div>
<div> [[File:Bakteriální endokarditis(28C).jpg|Detail|400px]] </div>
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<div class="note">'''Infectious endocarditis''' is an inflammation of the cardiac endocardium characterized by the presence of infectious vegetations (thrombus with microorganisms) on the valvular and/or mural endocardium.</div>

===Histology===
{{Details|Heart (histology)}}
===Cause===
Infection caused by [[staphylococcus|staphylococci]] (30-50 %), [[streptococcus|streptococci]], [[Streptococcus pneumoniae|pneumococci]], [[Enterococcus|enterococci]], [[Gram-negative anaerobic rods and cocci]] (''[[E.coli]]'')  and others.
===Pathogenesis===
It occurs in a heart both normal and with a previously altered endocardium (congenital malformations, [[acquired valvular defects]],  but also conditions after diagnostic or therapeutic procedures on the heart). Infection often occurs in [[Immunodeficiency|immunodeficient states]], [[neutropenia]], immunosupresion and intravenous drug addiction. A necessary condition for the development of bacterial endocarditis is the penetration of an infectious agent into the blood (bacteremia). The agent settles on the valve, leads to the formation of a thrombus, in which it multiplies.
===Macroscopy===
On the flaps there are vegetations of irregular shape, fragile, from a few mm to 2-3 cm, mostly brown-red in color. They tend to be located on the inflow surface of the left-sided heart valves (90% of cases), and can be multiple.
===Microscopy===
The thrombus consists mainly of '''fibrin''', in which are scattered multiple '''colonies of microorganisms''' (staphylococci) with '''leukocyte infiltrate'''. A thrombus can be organized to varying degrees by granulation tissue (healing). Leukocyte infiltration and [[necrosis]] are usually present in the adjacent valve .

===Prognosis and complications=== 
There is a risk of impaired function of the affected valve (formation of voluminous vegetation narrowing the lumen, local spread of inflammation, necrosis with ulceration, perforation or rupture and subsequent non-closing), [[embolism|embolization]] of infected thrombus fragments (septicopemia and the formation of abscesses in various organs, most often in the brain, kidneys, myocardium and skin ). Furthermore, immunocomplex impairment (local vasculitis).

===Occurence===
Often in immunodeficient states, immunosuppressed patients and intravenous drug addicts.
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===Related articles===

*[[Heart]]
*[[Infectious endocarditis]]
*[[Infectious endocarditis (pediatry)]]
*[[Endocarditis]]
*[[Non-infectious endocarditis]]
*[[Congenital cardial malformations]]

===External links===

*[http://www.patologie.info/vip/preparat.php?detail=349 Bakteriální endokarditída (vituální preparát)]

===Bibliography===

* {{Cite
| type = book
| isbn = 978-807262-494-2
| surname1 = Povýšil
| name1 = Ctibor
| surname2 = Šteiner
| name2 = Ivo
| surname3 = BARTONÍČEK
| name3 = Jan
| others = yes
| title = Speciální patologie
| edition = 2
| location = Praha
| publisher = Galén
| year = 2007
| range = 430
}}

* {{Cite
| type = book
| isbn = 978-80-247-1650-3
| surname1 = Brychtová
| name1 = Svetlana
| surname2 = Hlobilková
| name2 = Alice
| title = Histopatologický atlas
| edition = 1
| location = Praha
| publisher = Grada
| year = 2008
| range = 112
}}

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[[Category:Pathological slides (1. LF UK)]]
[[Category:Histology]]
[[Category:Pathology]]