Estudo sobre endocardite infecciosa em Ribeiräo Preto, SP - Brasil: análise de casos ocorridos entre 1992 e 1997 / A study of infectious endocarditis in Ribeiräo Preto, SP - Brazil: analysis of cases occuring between 1992 and 1997

RESUMO

OBJECTIVE: To analyze the epidemiology, diagnosis, clinical aspects causes and evolution of infectious endocarditis. METHODS: The patients analyzed were treated at the University Hospital of the Faculdade de Medicina of Ribeirão Preto-USP and had a diagnosis of infectious endocarditis defined by Duke's criteria, which classifies infectious endocarditis as native, prosthetic valve or that occurring in intravenous drug users. RESULTS: One hundred and eighty episodes of infectious endocarditis in 168 patients were observed. Echocardiograms in 132 (73.3 per cent) provided a diagnosis of infectious endocarditis in 111 (84 per cent) patients; mitral valves were affected in 55 (30.5 per cent), tricuspid valves in 30 (16.6 per cent) and the aortic valve in 28 (15.5 per cent) patients. Hemocultures were performed in 148 (93.8 per cent) episodes of IE. The most commonly isolated infectious organisms were Staphylococcus aureus in 46 (27.2 per cent) patients and Streptococcus viridans in 27 (15.9 per cent). Complications occurred in 116 (64.4 per cent) patients and 73 (40.5 per cent) of the patients died. CONCLUSION: The general profile of the observed infectious endocarditis was similar to that reported in studies performed in other countries and included users of intravenous drugs. The high degree of mortality observed is not compatible with progress in diagnosis and treatment of infectious endocarditis and is probably due to the absence of diagnostic suspicion. The high frequency of fatal cases of septicemia (45.1 per cent of deaths) in the patients studied indicates that unnoticed cases of infectious endocarditis had only been diagnosed at necropsy.