Twenty-Year Experience in the Diagnosis and Treatment of Infective Endocarditis

Abstract

AimsThe aim of this study was to compare the etiology, clinical course, selected diagnostic methods and efficacy of the treatment used in patients with infective endocarditis (IE) in the nineteen eighties and nineties.Material and MethodsThe study group comprised 300 patients with infective endocarditis hospitalized in the Institute of Cardiology in Warsaw in the following years: from 1982 to 1987 (150 patients: 75 successive patients with IE on the prosthetic valve and 75 successive patients with IE on the native valve), as well as from 1990 to 2003 (150 patients: 75 successive patients with IE on the prosthetic valve and 75 successive patients with IE on the native valve).ResultsIn the nineties, immunological symptoms, embolism formation and progressive heart failure were diagnosed decidedly more frequently. Early prosthetic valve endocarditis (PVE) (up to 60 days after operation) occurred significantly more frequently in the eighties. The quantity of negative blood cultures in PVE has not decreased, it is still observed in over 20% of cases. For 20 years the etiology of PVE has remained the same, the dominant pathogen remains Staphylococcus. The frequency of PVE caused by Streptococci has markedly reduced. In both the decades analyzed the etiology of native valve endocarditis (NVE) was similar. In the eighties Streptococcus was predominant. In successive years the number of infections caused by Staphylococci was the same as that caused by Streptococci.ConclusionsThe incidence of early PVE decreased in the nineties. More patients were treated surgically with lesser peri-operative mortality. A lower incidence of infective endocarditis on prosthetic valves caused by streptococci may signify better prophylaxis against infective endocarditis. Infective endocarditis with sterile blood cultures continues to occur frequently.

Clinical and pathogen features of infective endocarditis:A retrospective study of 111 episodes in a teaching hospital in southwest China

“…Some infectious markers, such as CRP, erythrocyte sedimentation rate, and neutrophil, may contribute to early detection of the disease. 10 In this study, more than 50% Staphylococcus spp is the most common cause of IE, followed by Streptococci spp 13,14 .Staphylococcus spp associate IE has became increasingly common in most industrialized countries because of increased medical intervention 5 ; meanwhile Streptococci spp has became less 15,16 . the presence of S. aureus bacteremia should be considered a major criterion, regardless of whether the infection is nosocomially acquired or whether a removable source of infection is present 17 .…”

A Series of Frustrations of Fever for Congenital Heart Disease: Case Report

“…Infective endocarditis with high morbidity and mortality is one of the most serious and destructive complication of valvular heart disease [2]. Congenital heart disease is a common cause of infective endocarditis [3], and studies have shown that the incidence can reach 10% to 14%, which is more common in VSD, congenital bicuspid aortic valve, patent ductus arteriosus (PDA), and tetralogy of Fallot.…”

Preliminary results from the Polish Infective Endocarditis Registry (POL-ENDO): Time to change clinical practice?

“…Individual studies revealed that the clinical profile of IE has changed over the past few decades [4,5]. Presented studies show several factors evolving over time, including risk factors, etiology and high prevalence of IE cases caused by nosocomial infections [6,7]. Data on the IE in Poland are very limited.…”