10.6.6 Cardiovascular infections
Bacterial infections of the cardiovascular system
are uncommon (Table 10.8). Injection- or intravenous
catheter-associated thrombophlebitis is likely
the most common problem; however, most cases of
thrombophlebitis are probably inflammatory versus
infection. Therefore, antimicrobials are not indicated
in all cases and should be reserved for situations
where there is a high likelihood of infectious thrombophlebitis
or associated abscessation. Bacterial
endocarditis and pericarditis are rare but potentially
life-threatening conditions requiring appropriate
therapy. Blood culture should be performed in cases
of endocarditis to identify the cause, while culture of
blood and pericardial fluid should be performed in
cases of suspected bacterial pericarditis. Pericardial fluid should be inoculated into blood culture broth
immediately after collection. Pericardial drainage and
lavage are important adjunctive treatments for pericarditis.
Surgical incision and drainage is required if
thrombophlebitis progresses to abscessation.