Infective Endocarditis

Suspect IE if ANY of: • New regurgitant murmur + fever • Bacteraemia with Staph. aureus, Streptococcus viridans, or Enterococcus • Prosthetic valve or intracardiac device + fever • Known congenital heart disease + fever • Embolic event (stroke, splenic infarct) + fever Initial investigations: • Blood cultures × 3 sets (from different sites, 30–60 min apart — before antibiotics) • FBC, CRP, ESR, U&E, LFTs, coagulation • Urinalysis (haematuria — immune complex GN) • ECG: new PR prolongation → perivalvular abscess • Echocardiography (TTE first; TOE if TTE negative/poor window or prosthetic valve)