[Bacterial endocarditis at a county hospital department, 1983-1992. Prognosis in relation to bacteriology, disease...

The case records of 69 patients with a diagnosis of bacterial endocarditis were reviewed. Forty-nine patients had native valve endocarditis (NVE) and 20 patients had prosthetic valve endocarditis (PVE). Among patients with NVE left-sided endocarditis was treated surgically more often than right-sided endocarditis. Involvement of the aortic valve was the most important indicator of death and acute/subacute surgical intervention. The mortality was 29%. No patient with right-sided endocarditis died. The infective agent did not seem to influence outcome or frequency of surgical intervention. Among patients with PVE the most frequently isolated organism was coagulasenegative staphylococci. Surgical intervention occurred most frequently in those with infection with coagulase-negative staphylococci or culture negative endocarditis. The mortality was 25%, identical for early and late cases. The patients who died were all infected with staphylococci. The localization did not seem to influence treatment or outcome. In spite of advances in surgical and medical treatment bacterial endocarditis is still a life-threatening disease with a high mortality.