Endocarditis Pathology Facts |
| 1. Vegetations (wether infectious or marantic) are most commonly observed on the line of closure of a valve. |
| 2. Valvular regurgitation results from valve perforation, ulceration, avulsion, or chordal rupture. |
| 3. Perivalvular abscess formation may lead to fistula formation between cardiac chambers or rupture into the pericardial space. |
| 4. Mural and valvular thrombi should be examined histologically to rule out an infectious etiology. |
| 5. Endocarditis of mechanical prosthetic valves begins in the sewing ring and is usually associated with annular abscess formation. |
| 6. Vegetations are composed of fibrin thrombi, neutrophilic infiltrates, microbial colonies, and necrotic debris. |
| 7. The pathologist should suspect infective endocarditis when a predominance of neutrophils is seen on histologic examination of valvular inflammatory infiltrates. |
| 8. Because bacteria may not stain with the Gram stain after antibiotic therapy, methenamine silver stain should always be performed, as it is able to demonstrate both bacterial and fungal organisms. |
