Prosthetic valve endocarditis.
From January 1963 until January 1974, 45 patients had prosthetic valve endocarditis. Symptoms of prosthetic valve endocarditis developed within 2 months after operation (early onset) in 16 patients (36%) and more than 2 months after operation (late onset) in 29 patients (64%). Overall mortality among the 45 patients was 56% (88% among those with early onset and 40% among those with late onset). Medical therapy alone was curative in 60% of the surviving patients. Combined medical and surgical therapy was curative in 40% of the survivors. The most frequent isolates in the early-onset group were Staphylococcus aureus (44%) and Gram-negative bacilli (38%); associated mortality was 86% and 83%, respectively. The most frequent isolates in the late-onset group were viridans streptococci (41%) and Gram-negative bacilli (31%); the mortality was 25% and 22% respectively. Suggestions are offered for operative antimicrobial prophylaxis and for medical and surgical treatment of prosthetic valve endocarditis. Prompt surgical replacement of an infected prosthesis is necessary when medical therapy fails.
D001419:Bacteria / Q000302:isolation & purification; D001769:Blood / Q000382:microbiology; D002175:Candida / Q000302:isolation & purification; D004617:Embolism / Q000209:etiology; D004697:Endocarditis, Bacterial / Q000209:etiology* / Q000401:mortality / Q000628:therapy; D006337:Heart Murmurs; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D006801:Humans; D012772:Shock, Septic / Q000209:etiology; D013163:Splenomegaly / Q000209:etiology; D013210:Staphylococcus / Q000302:isolation & purification; D013291:Streptococcus / Q000302:isolation & purification