Infective endocarditis in the 1980s: experience at a heart hospital.
Three hundred episodes of infective endocarditis (IE) in 287 patients were studied from October 1978 to August 1986. The patients were in the age range of 0.2-78 (mean 30.76 +/- 16.06) years; 185 (68%) occurred in male patients. The etiologic agents were: Streptococci viridans group (93), enterococci (21), streptococci D group, nonenterococci (19), other streptococci (14), Staphylococcus aureus (59), Staphylococcus epidermidis (14), gram-negative bacteria (16), other gram-positive bacteria (16), fungi (4). Etiologic agents were not isolated in 52 (negative cultures). Valvular heart diseases occurred in 231 episodes, congenital heart diseases in 37, other heart diseases in 6. Sixty-nine occurred in patients with prosthetic heart valves. In 69 there was no previous heart disease. Surgical treatment was performed in 102 episodes (37 with prosthetic valve IE and 65 with native valve IE); 22 patients (21%) died, 12 with prosthetic valve and 10 with native valve IE. The in-hospital mortality (medical and surgical patients) was 26% (78 patients). Long-term follow-up of 206 patients up to 7.1 (mean 2.13 +/- 1.68) years revealed that 26 patients died. Thus, IE remains a disease with high mortality and is fatal to a third of the patients, in spite of the progress in therapeutic methods. Its morbidity and mortality continues beyond the microbiological cure.
Instituto do Coração, Hospital das Clínicas da FMUSP, São Paulo, Brazil.
A J
AJ
Mansur
M
M
Grinberg
G
G
Bellotti
A
A
Jatene
F
F
Pileggi
D000293:Adolescent; D000328:Adult; D000368:Aged; D001938:Brazil / Q000453:epidemiology; D002309:Cardiology; D002648:Child; D002675:Child, Preschool; D004697:Endocarditis, Bacterial / Q000453:epidemiology*; D005260:Female; D006349:Heart Valve Diseases / Q000453:epidemiology; D006782:Hospitals, Special; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D012737:Sex Factors; D013203:Staphylococcal Infections / Q000453:epidemiology; D013290:Streptococcal Infections / Q000453:epidemiology; D013997:Time Factors