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Bacterial endocarditis in England in the 1970's: a review of 70 patients
Abstract:
The features of 70 cases of bacterial endocarditis are reported. Streptococcus viridans was the cause in 45 per cent, staphylococci in 27 per cent, and enterococci in 7 per cent. Rheumatic heart disease was the predisposing factor in less than one quarter of patients and in almost half there was no obvious pre-existing cardiac disease. Apart from cardiac murmurs and pyrexia, the classical features of infective endocarditis were uncommon, haematuria being observed in less than one-third. Most patients were over the age of 30, one-third more than 60 years of age and the peak incidence occurred in the seventh decade. The mortality was 34 per cent, being highest in infection caused by Staphylococcus aureus. Adverse prognostic features included cardiac failure, advanced age and peripheral embolization. One-third of infections were caused by bacteria resistant to penicillin.
Insights
This study on bacterial endocarditis found that Streptococcus viridans and staphylococci were common causes. High mortality was linked to Staphylococcus aureus infections and adverse prognostic factors.
Area of Science:
- Infectious Diseases
- Cardiology
- Internal Medicine
Background:
- Bacterial endocarditis is a serious infection affecting heart valves.
- Understanding causative agents and risk factors is crucial for patient outcomes.
Purpose of the Study:
- To report the clinical features, causative organisms, and outcomes of bacterial endocarditis.
- To identify predisposing factors and adverse prognostic indicators.
Main Methods:
- Retrospective analysis of 70 bacterial endocarditis cases.
- Review of patient demographics, clinical presentation, microbiology, and treatment outcomes.
Main Results:
- Streptococcus viridans (45%) and staphylococci (27%) were the most common pathogens.
- Predisposing factors included rheumatic heart disease (less than 25%) and no prior cardiac disease (almost 50%).
- Mortality was 34%, highest with Staphylococcus aureus; cardiac failure, advanced age, and embolization were poor prognostic signs. Penicillin-resistant bacteria caused one-third of infections.
Conclusions:
- Bacterial endocarditis presents with non-specific symptoms in many cases.
- Advanced age and specific bacterial agents like Staphylococcus aureus are associated with higher mortality.
- Antimicrobial resistance is a significant challenge in managing bacterial endocarditis.