[Clinical, echocardiographic and prognostic profile of Streptococcus viridans left-sided endocarditis].
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Published case series on Streptococcus viridans endocarditis are scarce and outdated.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.
López
Javier
J
Servicio de Cardiología, Instituto de Ciencias del Corazón (ICICOR), Hospital Clínico Universitario, Valladolid, España.
San Román
José A
JA
Revilla
Ana
A
Vilacosta
Isidre
I
Luaces
María
M
Sarriá
Cristina
C
Gómez
Itziar
I
Fernández-Avilés
Francisco
F
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*