Infective endocarditis in non-HIV immunosuppressed patients

Infective endocarditis is a septic illness with sudden or insidious onset that causes heart lesions or aggravates the preexisting ones; during its course it can affect other organs, mortality being high.

To identify non-HIV immunosuppressed patients with infective endocarditis, namely those with associated diabetes, hepatitis, cancer, or old age with multiple comorbidities, and to assess the nosocomial risk by Carmeli score.

This is a retrospective study using epidemiological, clinical, laboratory and treatment data from 56 patients admitted to and diagnosed with infective endocarditis at the lasi Infectious Diseases Hospital in the interval January 2008 - May 2012. To these patients we looked for non-HIV immunosuppressed character, having in their pathology association diabetes, chronic hepatitis, malignancy, or other comorbidities.

From the infective endocarditis patients, 92.8% were found non-HIV immunosuppressed, 25% of them presenting renal failure, and 21.1% having diabetes. The most common Carmeli score obtained was score 2 in 57.1% of the cases. In these patients, the most frequent etiologic agent of infective endocarditis was Enterococcus faecalis (16%), followed by Staphylococcus aureus (10.7%).

It was noted that in addition to endocardial damage due to the multiple etiologic agents involved, non-HIV immunosuppression in these patients plays an important role. The association of Carmeli score in patients diagnosed with infective endocarditis is significant, especially in case of adequate therapy initiation for a right treatment of this pathology.