Subject(s)
Aneurysm, Infected/diagnostic imaging , Carotid Artery, Internal , Carotid Stenosis/diagnostic imaging , Endocarditis, Bacterial/diagnostic imaging , Heart Valve Diseases/diagnostic imaging , Acute Disease , Adult , Aneurysm, Infected/microbiology , Anti-Bacterial Agents/therapeutic use , Carotid Stenosis/microbiology , Echocardiography, Doppler , Fever/microbiology , Humans , Magnetic Resonance Angiography , Male , Meningitis, Bacterial/drug therapy , Meningitis, Bacterial/microbiology , Mitral ValveABSTRACT
OBJECTIVE: To determine the clinical features and long term prognosis of infective endocarditis in patients who were not drug addicts. DESIGN: Prospective case series. SETTING: A university hospital that is both a referral and a primary care centre. PATIENTS: 138 consecutive cases of infective endocarditis diagnosed and treated from January 1987 to March 1997. RESULTS: Mean patient age was 44 (20) years old. 95 patients (69%) had native valve endocarditis and 43 (31%) had prosthetic valve endocarditis. Staphylococci were the causal microorganisms in 34% of cases and streptococci in 33%. Severe complications occurred in 83% of patients and 51% of patients underwent surgery during the active phase (22% was emergency surgery). Inpatient mortality was 21%. During a follow up of 56 (44) months, 10 patients (9%) needed late cardiac surgery and seven (5% of the whole series) died. Overall 10 year survival was 71%. There were no significant differences in survival depending on the type of treatment received during the hospital stay (medical or combined medical-surgical). CONCLUSIONS: A high early surgery rate is related to good long term results and does not increase in-hospital mortality. Medical treatment, however, also offers favourable long term results in cases of responsive infective endocarditis where poor prognostic factors are absent.
