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Infective endocarditis in the military patient
  1. Andrew Gough1,
  2. K Clay2,
  3. A Williams3,
  4. S Jackson4 and
  5. B Prendergast5
  1. 1Neurology department, Defence Medical Rehabilitation Centre (DMRC), Epsom, UK
  2. 2Department of Academic Medicine, Royal Centre for Defence Medicine, Birmingham, UK
  3. 3Cardiology Department, Royal Gwent Hospital, Newport, UK
  4. 4Directorate of Manning (Army), Marlborough Lines, Andover, UK
  5. 5Department of Cardiology, Guy's and St Thomas' Hospitals, London, UK
  1. Correspondence to Lt Col Andrew Williams, Cardiology Department, Royal Gwent Hospital, Cardiff Road, Newport NP20 2UB, UK; Andrew.Williams12{at}


Infective endocarditis (IE) is a potentially fatal cardiac infection associated with an inhospital mortality rate of up to 22%. Fifty per cent of IE cases develop in patients with no known history of valve disease. It is therefore important to remain vigilant to the possibility of the diagnosis in patients with a febrile illness and unknown source. From a military perspective, our patients are unique due to the breadth of pathogens they are exposed to, and blood-culture-negative IE is a risk. In particular, there should be awareness of Coxiella burnetii as a possible causative pathogen. In this review we incorporate the latest consensus from systematic reviews and publications identified by a literature search through Medline. We describe the diagnosis and management of IE with particular reference to the military population.


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