Endocarditis can be acquired in which settings?

• A. Hospital or community acquired.
• B. Only in hospital.
• C. Only in community.
• D. Not an infection.

Answer: (B)

Endocarditis can be acquired in both hospital and community settings. Bacteria can enter the bloodstream from dental work, poor dentition, skin infections, or injection drug use in the community, seeding heart valves. In the hospital, intravascular devices, prosthetic valves, and invasive procedures increase the risk of nosocomial or device-related endocarditis. Because the pathways for bacteremia exist in both environments, endocarditis is not confined to one setting or to not being an infection. The idea that it occurs only in the hospital or only in the community is inaccurate.