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A six years review on 53 cases of infective endocarditis: clinical, microbiological and therapeutical features
G Hollanders1, I De Scheerder, M De Buyzere
1Department of Cardiology, University Hospital, Gent, Belgium.
Abstract:
Microbiological features, diagnostic investigations, treatment, and complication rate in 53 cases of infective endocarditis were reviewed in this study. Infection occurred both on prosthetic (47%) and native valves (38%), while in 15% of the cases no prior valvular disease was known. Streptococcal (38%) and staphylococcal (30%) infections were predominant. In 17% of the cases apparent negative blood cultures were obtained. The most frequent portal of entry was dental infection or manipulation (45%), however in 28% of the patients etiology remained obscure. Major clinical signs and symptoms included heart murmurs (96%), fever (91%), dyspnoea (32%), and splenomegaly (30%). Echocardiography revealed vegetations in 78%, aortic and mitral valve being nearly equally affected. All patients were medically treated and 53% received antibiotics prior to blood cultures. Associations of ampicillin or penicillin with an aminoglycoside (43%) and penicillinase-resistant antibiotics (30%) were most frequently administered. In 28% of the patients, it was necessary to insert a prosthetic (aortic or mitral) valve. During follow-up, heart failure (28%), embolization (11%), and infections (11%) were the major complications.
Insights
This study reviewed 53 infective endocarditis cases, finding streptococcal and staphylococcal infections common. Management involved antibiotics and surgery, with heart failure and embolization as key complications.
Area of Science:
- Cardiology
- Infectious Diseases
- Microbiology
Background:
- Infective endocarditis (IE) is a serious infection affecting heart valves.
- Understanding microbiological features, diagnostics, and outcomes is crucial for patient management.
Purpose of the Study:
- To review microbiological features, diagnostic methods, treatment strategies, and complication rates in a cohort of 53 infective endocarditis patients.
Main Methods:
- Retrospective review of 53 cases of infective endocarditis.
- Analysis of microbiological data, clinical presentation, diagnostic investigations (including echocardiography), treatment regimens, and complication rates.
Main Results:
- Predominant pathogens were Streptococcal (38%) and Staphylococcal (30%).
- Infection affected prosthetic (47%) and native valves (38%).
- Common symptoms included heart murmurs (96%) and fever (91%). Echocardiography detected vegetations in 78%.
Conclusions:
- Infective endocarditis presents with diverse microbiological origins and clinical signs.
- Prompt diagnosis and appropriate antibiotic therapy, often combined with surgical intervention, are essential.
- Heart failure and embolization remain significant complications requiring vigilant monitoring.