Classification The classification of IE is outlined in Table 56.1 Currently, only approximately 10% of pediatric IE is a native valve endocarditis (NVE) Table 56.1 Classification of Infective Endocarditis (IE) ACCORDING TO LOCALIZATION AND PRESENCE/ABSENCE OF INTRACARDIAC MATERIAL Left-sided native valve IE Left-sided prosthetic valve IE Early 1 year after replacement Right-sided IEa Cardiac device–related IEb ACCORDING TO MODE OF ACQUISITION Health care–associated IE Nosocomial Hospitalized >48 h prior to onset of symptoms Nonnosocomial Hospitalized 90% of patients) IE must be suspected if fever is associated with: a Intracardiac prosthetic material (e.g., prosthetic valve, pacemaker, implantable cardioverter defibrillator, surgical baffle/conduit) b Previous history of IE c Previous valvar or congenital heart disease d Other predisposition for IE (e.g., immunocompromised, intravenous drug users) e Predisposition and recent intervention with associated bacteremia f New congestive heart failure g New conduction disturbance h Positive blood culture with typical IE causative organism or positive serology for Q-fever or Bartonella (microbiologic findings may precede cardiac manifestations) i Vascular or immunologic phenomena: embolic event, Roth spots, splinter hemorrhages, Janeway lesions, Osler nodes j Focal or nonspecific neurologic symptoms and signs k Evidence of pulmonary embolism/infiltration (right-sided IE) l Peripheral abscesses (renal, splenic, cerebral, vertebral) of unknown cause IE, Infective endocarditis