[Subacute infectious endocarditis in the elderly. Retrospective study of 33 cases]

The authors reviewed 33 cases of infectious endocarditis in patients over 65 years of age and classified according to Von Reyn's diagnostic criteria. Twenty-four patients had organic valvular disease, 4 had a prosthetic valve, and in 4 cases the diagnosis of the murmur was uncertain. Positive blood cultures were obtained in 79 p. 100 of cases. The commonest infecting organism was the streptococcus (21 out of 26). In 11 patients, it was a Group D streptococcus and a recto-sigmoid colonic tumour was found in 3 cases. A dental portal of entry was suspected in 55 p. 100 of patients and this should guide the choice of prophylactic antibiotic therapy. The initial choice of antibiotic had to be changed in 19 patients, usually because of poor tolerance. Eight patients died and one underwent valve replacement within two months of hospital admission.