[Etiology and clinical course of bacterial endocarditis, 1971-1980]

Etiology and clinical course of infective endocarditis were analyzed in 31 patients seen at this institution between 1971 and 1980. The follow-up period averaged 60 (1-180) months. The infection relapsed 9 times (relapse rate 31-38%). The etiologic agent isolated from blood cultures in 26/42 infective episodes. Penicillin-sensitive streptococci were by far the most frequent cause of infective endocarditis (46%), followed by Staphylococcus aureus in 23%. A predisposing cardiac lesion existed in 26/31 patients (84%), aortic valve disease and a prolapsing mitral valve being the most frequent. In the 31 patients there were 5 deaths, 2 of which occurred acutely within a few days following the onset of endocarditis (mortality rate 6%), 2 suddenly after completion of antimicrobial therapy and 1 from another cause during the observation period. Surgery was necessary in 18 patients, emergency valve replacement being required in 3 cases (10%). In 15 patients (52%) cardiac surgery was performed electively after healing of the endocarditis. The indication for surgery was onset of heart failure due to valvular incompetence in 16 patients and recurrent systemic embolization in 2 patients. All patients survived surgery. At restudy no difference was observed in overall cardiac function, physical working capacity and employment activities among the surviving patients whether operated upon or not.