[Infectious endocarditis at Ullevål hospital 1988-94. Echocardiographic investigation]

Area of Science:

• Infectious Diseases
• Cardiology
• Microbiology

Background:

• Infectious endocarditis (IE) is a serious infection affecting heart valves.
• Accurate diagnosis and etiological identification are crucial for patient management.
• Echocardiography has improved diagnostic capabilities for IE.

Purpose of the Study:

• To analyze the clinical characteristics, etiological agents, and outcomes of infectious endocarditis.
• To evaluate the diagnostic challenges and effectiveness of echocardiography in IE.
• To compare case fatality rates between different etiological agents.

Main Methods:

• Retrospective analysis of 68 patients diagnosed with infectious endocarditis over a seven-year period (1988-1994).
• Identification of etiological agents, including Staphylococcus aureus and Streptococcus viridans.
• Review of diagnostic methods, including autopsy findings and echocardiography (transthoracic and transesophageal).

Main Results:

• Staphylococcus aureus (38%) and Streptococcus viridans (21%) were the most common pathogens.
• Case fatality was 34% overall, significantly higher for S. aureus (48%) vs. S. viridans (7%) endocarditis (p=0.01).
• 23% of patients lacked a definitive clinical diagnosis despite advanced imaging; 7 diagnoses were made post-mortem.

Conclusions:

• Staphylococcus aureus poses a higher mortality risk in infectious endocarditis compared to Streptococcus viridans.
• Echocardiography is valuable for IE diagnosis and follow-up, but clinical diagnosis remains challenging.
• Early and accurate diagnosis is critical for improving outcomes in infectious endocarditis.