title: Multi-valvular endocarditis.
abstract: OBJECTIVE
  Seventy-seven cases of native valve infective endocarditis as determined by the Duke criteria, were reviewed to determine the incidence and clinical features of multi-valvular endocarditis.
  
  
  METHODS
  Fourteen of 77 patients (18%) had multi-valvular endocarditis most commonly involving the mitral and aortic valves. Staphylococcus aureus (43%) and viridans streptococci (36%) were the most common organisms causing multi-valvular endocarditis.
  
  
  RESULTS
  Definite or probable vegetations were found in 50% of the patients by two-dimensional transthoracic echocardiograph and/or transesophageal echocardiograph, and possible vegetations were detected in 21%. The overall mortality in our series was 21%; 29% underwent valve replacement and 50% were treated medically. The major complications of multi-valvular endocarditis were congestive heart failure (64%), acute renal failure (50%), embolic events (21%), and splenic abscess/infarcts (21%).
  
  
  CONCLUSIONS
  Our data suggests complications of multi-valvular endocarditis, compared with uni-valvular endocarditis are similar except for heart failure. Heart failure is statistically more common in multi-valvular endocarditis (P < or = 0.002).
authors.affiliation: Infectious Disease Division, Winthrop-University Hospital, Mineola, New York 11501, USA.
authors.forename: N
authors.initials: N
authors.lastname: Kim
authors.forename: J M
authors.initials: JM
authors.lastname: Lazar
authors.forename: B A
authors.initials: BA
authors.lastname: Cunha
authors.forename: W
authors.initials: W
authors.lastname: Liao
authors.forename: V
authors.initials: V
authors.lastname: Minnaganti
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004452:Echocardiography; D004697:Endocarditis, Bacterial / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology* / Q000382:microbiology; D005260:Female; D006333:Heart Failure / Q000209:etiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology; D013211:Staphylococcus aureus / Q000302:isolation & purification*; D013290:Streptococcal Infections / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology; D013291:Streptococcus / Q000302:isolation & purification*