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Diagnostic and Therapeutic Challenges in Infective Endocarditis

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiology".

Deadline for manuscript submissions: 25 September 2025 | Viewed by 346

Special Issue Editor


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Guest Editor
Department of Precision Medicine, University of Campania ‘L. Vanvitelli’, Via de Crecchio, 7, 80138 Napoli, Italy
Interests: cardiovascular infections; infective endocarditis; CIED infection; antimicrobial therapy; gram negative MDR microorganism

Special Issue Information

Dear Colleagues

In the past two decades, Infective Endocarditis (IE) has become an extremely heterogeneous disease, accompanied by an epidemiological shift towards older comorbid patients with valve prosthesis and intracardiac devices that may present with atypical symptoms and uncommon aetiology.

Despite recent advancements in the field, the prognosis of IE remains poor, with an in-hospital mortality rate peaking at 20-25%. Clinicians dealing with cardiovascular infections are called to handle a wide number of diagnostic challenges related to possible inconclusive echocardiography and to difficulties in isolating the causative microorganism. Moreover, patients with IE need a tailored medical and surgical management, sometimes based on low-quality supporting evidence and expert opinions. In this scenario, the multidisciplinary approach represented by the Endocarditis Team is of pivotal importance.

This Special Issue aims to foster interaction between different medical specialists caring for IE patients and to facilitate the spreading of medical knowledge by welcoming the submission of observational, single-centre or multi-centre, retrospective and prospective studies together with case series, clinical case reports and narrative literature reviews focusing on the diagnostic and therapeutic management of IE.

Dr. Lorenzo Bertolino
Guest Editor

Manuscript Submission Information

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Keywords

  • infective endocarditis
  • complications
  • diagnostic challenges
  • therapeutic approach
  • epidemiology
  • clinical correlates

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Published Papers (1 paper)

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Review

25 pages, 1917 KiB  
Review
Deciphering the Complex Relationships Between the Hemostasis System and Infective Endocarditis
by Muhammad Aamir Wahab, Atta Ullah Khan, Silvia Mercadante, Iolanda Cafarella, Lorenzo Bertolino and Emanuele Durante-Mangoni
J. Clin. Med. 2025, 14(11), 3965; https://doi.org/10.3390/jcm14113965 - 4 Jun 2025
Viewed by 11
Abstract
Infective endocarditis (IE) arises from complex interactions between microbial pathogens and host hemostasis systems, where dysregulated coagulation mediates microbial persistence and systemic thromboembolic complications. Alterations in primary, secondary, and tertiary hemostasis in the acute IE phase have direct clinical implications for vegetation formation [...] Read more.
Infective endocarditis (IE) arises from complex interactions between microbial pathogens and host hemostasis systems, where dysregulated coagulation mediates microbial persistence and systemic thromboembolic complications. Alterations in primary, secondary, and tertiary hemostasis in the acute IE phase have direct clinical implications for vegetation formation and detachment. Staphylococcus aureus is one of the most common pathogens that causes IE, and it is capable of profoundly altering the coagulation cascade through several mechanisms, such as platelet activation, prothrombin activation through staphylocoagulase release, and plasminogen stimulation via staphylokinase production. Understanding these complex and yet unmasked mechanisms is of pivotal importance to promoting targeted therapeutic intervention aimed at reducing IE morbidity and mortality. Moreover, the management of antiplatelet and anticoagulant treatment during IE onset is a controversial issue and needs to be tailored to patient comorbidities and IE-related complications, such as cerebral embolism. This review provides a roadmap to promote clinicians’ understanding of the complex interactions between hemostasis and IE clinical manifestations and complications, discussing pathogen-specific coagulation profiles while addressing critical knowledge gaps for IE management. Full article
(This article belongs to the Special Issue Diagnostic and Therapeutic Challenges in Infective Endocarditis)
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