Enterococcus faecalis infective endocarditis: focus on clinical aspects.
Enterococcus faecalis infective endocarditis (IE) is a disease of increasing importance, with more patients infected, increasing frequency of health-care associated infections and increasing incidence of antimicrobial resistances. The typical clinical presentation is a subacute course with fever, malaise and generalized aches, difficult to distinguish from other more common diseases. Of paramount importance is transthoracic- and transesophageal-echocardiography to establish the diagnosis. At the moment, the predominant strategies recommend ampicillin in combination with either gentamicin or ceftriaxone. E. faecalis infective endocarditis continues to be a very serious disease with considerable percentages of high-level gentamicin resistant strains and in-hospital mortality around 20%. Strategies to prevent E. faecalis IE, improve diagnostics, optimize treatment and reduce morbidity will be necessary to improve the overall prognosis.
Gentofte University Hospital, Niels Andersens vej 65, 2900 Hellerup, Denmark.
Anders
A
Dahl
Niels Eske
NE
Bruun
D000667:Ampicillin / Q000627:therapeutic use*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002443:Ceftriaxone / Q000627:therapeutic use*; D004359:Drug Therapy, Combination / Q000379:methods; D004697:Endocarditis, Bacterial / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology; D013293:Enterococcus faecalis / Q000302:isolation & purification*; D006801:Humans
D000900:Anti-Bacterial Agents; D002443:Ceftriaxone; D000667:Ampicillin