title: Pay attention to valvular disease in the presence of atopic dermatitis.
abstract: BACKGROUND
  Atopic dermatitis (AD) is a common skin condition in which Staphylococcus (S.) aureus can cause native valve destruction in patients with infective endocarditis (IE). The aim of this study was to determine the early and late outcomes of IE and AD.
  
  
  RESULTS
  The medical records of patients with IE and AD who presented between January 1997 and September 2010 were analyzed retrospectively. IE and AD patients were compared with those with IE without AD. The mean follow-up period was 5.5±3.4 years. The incidence of AD among IE patients was 6.7% and they were significantly younger than those without AD (28.4 years vs. 53.7 years; P<0.0001). Methicillin-sensitive S. aureus and Streptococcus species were more prevalent in IE with AD (P<0.0001) and without AD (P=0.0259), respectively. One developed postoperative mediastinitis caused by methicillin-resistant S. aureus despite preoperative skin care. None of the patients died in hospital or had IE recurrence. Freedom from recurrent IE or prosthetic valve endocarditis at 5 years was 100±0.0%.
  
  
  CONCLUSIONS
  Patients with IE must be checked for AD and history of AD because AD patients have a high incidence of staphylococcal colonization in their skin lesion.
authors.affiliation: Department of Cardiovascular Surgery, Kobe City Medical Center General Hospital, Kobe, Japan. naotowakimachi@hotmail.co.jp
authors.forename: Naoto
authors.initials: N
authors.lastname: Fukunaga
authors.forename: Yukikatsu
authors.initials: Y
authors.lastname: Okada
authors.forename: Yasunobu
authors.initials: Y
authors.lastname: Konishi
authors.forename: Takashi
authors.initials: T
authors.lastname: Murashita
authors.forename: Tadaaki
authors.initials: T
authors.lastname: Koyama
mesh_terms: D000328:Adult; D000368:Aged; D003876:Dermatitis, Atopic / Q000150:complications / Q000453:epidemiology / Q000382:microbiology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006349:Heart Valve Diseases / Q000150:complications / Q000453:epidemiology / Q000382:microbiology / Q000601:surgery*; D006801:Humans; D015994:Incidence; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus; D008875:Middle Aged; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000150:complications / Q000453:epidemiology / Q000601:surgery*; D013290:Streptococcal Infections / Q000150:complications / Q000453:epidemiology / Q000601:surgery*; D013291:Streptococcus