title: Characteristics and prognosis of pneumococcal endocarditis: a case-control study.
abstract: Case series have suggested that pneumococcal endocarditis is a rare disease, mostly reported in patients with co-morbidities but no underlying valve disease, with a rapid progression to heart failure, and high mortality. We performed a case-control study of 28 patients with pneumococcal endocarditis (cases), and 56 patients with non-pneumococcal endocarditis (controls), not matched for sex and age, during the years 1991-2013, in one referral centre. Alcoholism (39.3% versus 10.7%; p <0.01), smoking (60.7% versus 21.4%; p <0.01), the absence of previously known valve disease (82.1% versus 60.7%; p 0.047), heart failure (64.3% versus 23.2%; p <0.01) and shock (53.6% versus 23.2%; p <0.01) were more common in pneumococcal than in non-pneumococcal endocarditis. Cardiac surgery was required in 64.3% of patients with pneumococcal endocarditis, much earlier than in patients with non-pneumococcal endocarditis (mean time from symptom onset, 14.1 ± 18.2 versus 69.0 ± 61.1 days). In-hospital mortality rates were similar (7.1% versus 12.5%). Streptococcus pneumoniae causes rapidly progressive endocarditis requiring life-saving early cardiac surgery in most cases.
authors.affiliation: Department of Cardio-Thoracic and Vascular Surgery, Pontchaillou University Hospital, Rennes, France.
authors.forename: M
authors.initials: M
authors.lastname: Daudin
authors.affiliation: Department of Infectious Disease and Intensive Care Unit, Pontchaillou University Hospital, Rennes, France; CIC Inserm 0203, Rennes-1 University, France; Inserm U835, Rennes-1 University, France.
authors.forename: P
authors.initials: P
authors.lastname: Tattevin
authors.affiliation: Department of Cardio-Thoracic and Vascular Surgery, Pontchaillou University Hospital, Rennes, France.
authors.forename: B
authors.initials: B
authors.lastname: Lelong
authors.affiliation: Department of Cardio-Thoracic and Vascular Surgery, Pontchaillou University Hospital, Rennes, France.
authors.forename: E
authors.initials: E
authors.lastname: Flecher
authors.affiliation: Department of Infectious Disease and Intensive Care Unit, Pontchaillou University Hospital, Rennes, France.
authors.forename: S
authors.initials: S
authors.lastname: Lavoué
authors.affiliation: Department of Bacteriology, Pontchaillou University Hospital, Rennes, France.
authors.forename: C
authors.initials: C
authors.lastname: Piau
authors.affiliation: Department of Cardio-Thoracic and Vascular Surgery, Pontchaillou University Hospital, Rennes, France.
authors.forename: A
authors.initials: A
authors.lastname: Ingels
authors.affiliation: Department of General Medicine, Pontchaillou University Hospital, Rennes, France.
authors.forename: A
authors.initials: A
authors.lastname: Chapron
authors.affiliation: Department of Cardio-Thoracic and Vascular Surgery, Pontchaillou University Hospital, Rennes, France.
authors.forename: J-C
authors.initials: JC
authors.lastname: Daubert
authors.affiliation: Department of Infectious Disease and Intensive Care Unit, Pontchaillou University Hospital, Rennes, France; CIC Inserm 0203, Rennes-1 University, France; Inserm U835, Rennes-1 University, France. Electronic address: matthieu.revest@chu-rennes.fr.
authors.forename: M
authors.initials: M
authors.lastname: Revest
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006348:Cardiac Surgical Procedures; D016022:Case-Control Studies; D004696:Endocarditis / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D005260:Female; D006761:Hospitals; D006801:Humans; D008297:Male; D008875:Middle Aged; D011008:Pneumococcal Infections / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D011379:Prognosis; D013296:Streptococcus pneumoniae / Q000302:isolation & purification*; D016019:Survival Analysis; D016896:Treatment Outcome
keywords: Cardiac surgery; Streptococcus pneumoniae; case–control study; endocarditis; heart failure