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Fever during treatment of infective endocarditis

A Douglas, J Moore-Gillon, S Eykyn

    Lancet (London, England)
    |June 14, 1986
    PubMed

    Insights

    Persistent fever in infective endocarditis (IE) is common, often due to extensive infection requiring surgery, not antibiotic resistance. Seek expert cardiac consultation for persistent fever during IE treatment.

    Area of Science:

    • Cardiology
    • Infectious Diseases
    • Cardiac Surgery

    Background:

    • Infective endocarditis (IE) is a serious infection affecting heart valves.
    • Persistent or recurrent fever occurs in a significant proportion of patients despite antibiotic treatment.

    Purpose of the Study:

    • To investigate the causes of persistent or recurrent fever in culture-positive native valve infective endocarditis.
    • To guide management strategies for fever during IE treatment.

    Main Methods:

    • Retrospective analysis of 83 episodes of culture-positive native valve infective endocarditis.
    • Evaluation of causes for persistent or recurrent fever.

    Main Results:

    • Fever persisted or recurred in 50% of patients despite appropriate antibiotics.
    • The most common cause was extensive valve ring infection, necessitating surgery.
    • Other causes included emboli and drug hypersensitivity; antibiotic resistance was not a cause.

    Conclusions:

    • Persistent fever in IE is typically due to extensive infection, not antibiotic resistance.
    • Early consultation with cardiology and cardiac surgery is crucial for timely intervention, especially valve replacement.
    • Altering antibiotic therapy for fever should be resisted unless drug hypersensitivity is suspected.

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