A six years review on 53 cases of infective endocarditis: clinical, microbiological and therapeutical features.
Microbiological features, diagnostic investigations, treatment, and complication rate in 53 cases of infective endocarditis were reviewed in this study. Infection occurred both on prosthetic (47%) and native valves (38%), while in 15% of the cases no prior valvular disease was known. Streptococcal (38%) and staphylococcal (30%) infections were predominant. In 17% of the cases apparent negative blood cultures were obtained. The most frequent portal of entry was dental infection or manipulation (45%), however in 28% of the patients etiology remained obscure. Major clinical signs and symptoms included heart murmurs (96%), fever (91%), dyspnoea (32%), and splenomegaly (30%). Echocardiography revealed vegetations in 78%, aortic and mitral valve being nearly equally affected. All patients were medically treated and 53% received antibiotics prior to blood cultures. Associations of ampicillin or penicillin with an aminoglycoside (43%) and penicillinase-resistant antibiotics (30%) were most frequently administered. In 28% of the patients, it was necessary to insert a prosthetic (aortic or mitral) valve. During follow-up, heart failure (28%), embolization (11%), and infections (11%) were the major complications.
Hollanders
G
G
Department of Cardiology, University Hospital, Gent, Belgium.
De Scheerder
I
I
De Buyzere
M
M
Ingels
G
G
Bogaert
S
S
Clement
D L
DL
D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D004452:Echocardiography; D004697:Endocarditis, Bacterial / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D005260:Female; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000628:therapy; D013290:Streptococcal Infections / Q000175:diagnosis / Q000628:therapy
D000900:Anti-Bacterial Agents