Elderly Endocarditis: Understanding the Causes and Risk Factors

Endocarditis in the elderly population can be broadly categorized into two types: infectious and non-infectious. The majority of cases, however, fall under the category of infectious endocarditis, which is primarily caused by bacterial infections.

Common Pathogens Involved

Among the infectious types, streptococci and staphylococci are the most common causative agents. In particular, viridans group streptococci are frequently observed in cases of streptococcal endocarditis. These bacteria are part of the normal flora in the mouth and can enter the bloodstream through dental procedures or poor oral hygiene.

Role of Enterococci and Underlying Conditions

Enterococci, another type of bacteria, can also lead to endocarditis, especially in older male patients. This is often linked to underlying urological conditions such as prostate disease, which may result in urinary tract infections. These infections can become a source of bacteremia, leading to heart valve infection.

Common Routes of Infection

Infections that lead to endocarditis can originate from various parts of the body. Common entry points include the oral cavity, genitourinary system, gastrointestinal tract, and respiratory system. Procedures such as dental work, urinary catheterization, or gastrointestinal endoscopy can introduce bacteria into the bloodstream.

Impact of Medical Advancements

With the increasing frequency of invasive medical procedures and diagnostic tests, the incidence of bacteremia has also risen. This makes elderly individuals more susceptible to developing infectious endocarditis, especially those with pre-existing heart conditions or weakened immune systems.