title: [Clinical, echocardiographic and prognostic profile of Streptococcus viridans left-sided endocarditis].
abstract: OBJECTIVE
  Published case series on Streptococcus viridans endocarditis are scarce and outdated. The aims of our study were multiple: to analyze the profile of the Streptococcus viridans endocarditis, to compare it with other types of left-sided endocarditis and with cases caused by Staphylococcus aureus, and to determine predictors of poor outcome in Streptococcus viridans endocarditis.
  
  
  METHODS
  We analyzed 441 episodes of endocarditis: 330 left-sided and 54 caused by Streptococcus viridans (16%). We compared the 54 cases due to Streptococcus viridans with the remaining cases of left-sided endocarditis in our series, and also with cases caused by Staphylococcus aureus. We also analyzed the predictors of death and urgent surgery in Streptococcus viridans endocarditis.
  
  
  RESULTS
  Left-sided endocarditis due to Streptococcus viridans led to a similar degree of valvular destruction, showed acute onset less frequently, and led to less renal failure, septic shock and mortality than the remaining cases of left-sided endocarditis in our series. The same differences were found in comparison to Streptococcus viridans endocarditis. Prognostic factors for Streptococcus viridans left-sided endocarditis were heart failure and periannular complications.
  
  
  CONCLUSIONS
  Although Streptococcus viridans is a nonaggressive microorganism, valvular destruction is similar to that caused by other pathogens when it causes left-sided endocarditis. Nonetheless its prognosis is better, a feature which may be related to the fact that the systemic infectious syndrome can be treated more effectively. Prognostic factors in left-sided endocarditis due to Streptococcus viridans are heart failure and periannular complications.
authors.affiliation: Servicio de Cardiología, Instituto de Ciencias del Corazón (ICICOR), Hospital Clínico Universitario, Valladolid, España.
authors.forename: Javier
authors.initials: J
authors.lastname: López
authors.forename: José A
authors.initials: JA
authors.lastname: San Román
authors.forename: Ana
authors.initials: A
authors.lastname: Revilla
authors.forename: Isidre
authors.initials: I
authors.lastname: Vilacosta
authors.forename: María
authors.initials: M
authors.lastname: Luaces
authors.forename: Cristina
authors.initials: C
authors.lastname: Sarriá
authors.forename: Itziar
authors.initials: I
authors.lastname: Gómez
authors.forename: Francisco
authors.initials: F
authors.lastname: Fernández-Avilés
mesh_terms: D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000382:microbiology; D015150:Echocardiography, Doppler; D017548:Echocardiography, Transesophageal; D004697:Endocarditis, Bacterial / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000382:microbiology*; D005260:Female; D006350:Heart Valve Prosthesis / Q000382:microbiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000382:microbiology; D011379:Prognosis; D013030:Spain / Q000453:epidemiology; D013203:Staphylococcal Infections / Q000000981:diagnostic imaging / Q000382:microbiology; D013211:Staphylococcus aureus / Q000302:isolation & purification; D013290:Streptococcal Infections / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000382:microbiology*; D034363:Viridans Streptococci / Q000302:isolation & purification*