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Infective endocarditis of presumed dental origin and the new NICE guidelines: a case report
Author(s) -
de Gea Rico A.,
Williams J.V.,
Ranjadayalan K.,
Revington P.J.
Publication year - 2012
Publication title -
oral surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.156
H-Index - 11
eISSN - 1752-248X
pISSN - 1752-2471
DOI - 10.1111/j.1752-248x.2012.01155.x
Subject(s) - medicine , nice , infective endocarditis , lethargy , malaise , nausea , streptococcus mitis , endocarditis , intensive care medicine , sore throat , pediatrics , surgery , streptococcus , biology , computer science , bacteria , genetics , programming language
Antimicrobial prophylaxis against infective endocarditis (IE) in patients undergoing interventional procedures is no longer recommended. We present a case of IE following dental treatment for which NICE guidelines were followed. Case report: A 59‐year‐old gentleman presented with a 1 week history of general malaise, nausea, loss of appetite and lethargy after minimal exertion. Known mitral valve prolapse was reported, and an initial differential diagnosis included subacute bacterial endocarditis. An echocardiogram and Streptococcus mitis growth in the blood cultures supported the likely diagnosis. He was referred to the Oral and Maxillofacial Surgery Department where his previous dental history revealed dental treatment 1 month before admission. In line with the current National Institute for Health and Clinical Excellence (NICE) guidelines, the patient did not receive antibiotics preoperatively. Discussion: Dental professionals should be able to recognise the signs and symptoms of IE. It is important to remain informed about such a pathological entity and be aware of its diagnosis and management. Patients with certain cardiac conditions who are at increased risk of developing IE still remain at risk, despite the recent change in the NICE guidelines. The promotion of preventive dentistry and medicine is crucial to reduce the overall risk of IE.