[Infective endocarditis in 100 patients subjected to heart transplantation].
OBJECTIVE
An analysis of occurence, etiology, clinical aspects and death rate of infectious endocarditis cases involving patients who underwent heart transplantation.


METHODS
100 consecutive heart transplant patients were analysed; follow-up varied from three to 90 (medium of 25.38, SD +/- 27.97) months. Diagnostic criteria for endocarditis were those of the epidemiology and quality control service, Heart Institute, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, that agree with those of the Center for Disease Control. Diagnosis was established mostly by blood cultures, echocardiograms, either transthoracic or esophageal and autopsy.


RESULTS
Six cases of endocarditis were recognized, with four deaths; in three of those we found severe systemic compromise. All cases had fever as an important symptom.


CONCLUSIONS
Death risk seems high of infectious endocarditis after heart transplantation. The cause of this high risk appears to be linked to the bacteria themselves, to association with other clinical situations and to the use of immunosuppresive agents. We recommend a high index of suspition when risk factors are present in order to make a rapid diagnosis soon enough in the natural history of the disease; treatment has to be started as soon as possible.
Uip
D E
DE
Instituto do Coração do Hospital das Clínicas-FMUSP, São Paulo.
Neto
V A
VA
Strabelli
T M
TM
Bocchi
E A
EA
Pileggi
F
F
Jatene
A D
AD
Stolf
N
N
Fiorelli
A
A
Bellotti
G
G
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D004696:Endocarditis / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D016027:Heart Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies
Endocardite infecciosa em 100 pacientes submetidos a transplante cardíaco.