INFECTIVE ENDOCARDITIS: A REVIEW OF ITS PATHOPHYSIOLOGICAL MECHANISM AND THERAPEUTIC CHALLENGES

Abstract

Introduction: Infective endocarditis is an infection of the endocardium, the inner layer of the heart, which includes the heart valves. This condition is often caused by bacteria such as Staphylococcus aureus and Streptococcus viridans, although other microorganisms can also be involved. The clinical relevance of IE is significant due to its impact on public health, resulting in high morbidity and mortality. Objective: The present study aims to analyze documented updates regarding infective endocarditis concerning its pathogenic mechanism and existing therapeutic challenges. Methodology: The study adopted a literature review using Google Scholar and PubMed. Articles published between 2019 and 2024 in Portuguese, English, or Spanish were included. Inclusion criteria focused on studies about pathogenic mechanisms and therapeutic challenges. After selection, 22 articles were reviewed. Results: The pathogenesis of IE involves the initial adhesion of pathogens to the cardiac endothelium, followed by the formation of vegetations composed of platelets, fibrin, and microbial colonies. These vegetations can detach, causing embolization and systemic complications. Additionally, the inflammatory response mediated by cytokines contributes to valvular deterioration. Bacterial resistance and the need for prolonged antimicrobial therapy represent critical therapeutic challenges. Conclusion: The diversity of etiological agents and predisposing factors complicates the diagnosis and treatment of IE. The variability of clinical manifestations and emerging bacterial resistance highlight the need for therapeutic innovations. Furthermore, improved preventive strategies and advances in surgical techniques are essential to enhance clinical outcomes and reduce mortality associated with infective endocarditis.