 |
|
The Complications of Infective EndocarditisA Reappraisal in the 1980s
Alfredo Jose Mansur, MD;
Max Grinberg, MD;
Protasio Lemos da Luz, MD;
Giovanni Bellotti, MD
Arch Intern Med. 1992;152(12):2428-2432.
Abstract
| |
Background.—
The frequency of complications of infective endocarditis and their influence on the outcome of the patients changed in the antibiotic era. Therefore, we evaluated the complications in a recent large series of patients with infective endocarditis.
Methods.—
We studied 300 episodes of endocarditis in 287 patients in a tertiary cardiology referral center. Predisposing cardiac conditions were valvular heart disease in 147 episodes, congenital heart disease in 37, other heart diseases in five, and prosthetic heart valves in 69. In 69 episodes, there was no previous heart disease. The infecting microorganisms were streptococci in 147 episodes, Staphylococcus aureus in 59, Staphylococcus epidermidis in 14, gram-negative bacteria in 16, other gram-positive bacteria in eight, and fungi in four. In 52 episodes, blood cultures were negative. Seventy-eight patients (26%) died. Complications were defined as any clinically unfavorable event occurring during treatment.
Results.—
A total of 386 complications occurred in 223 episodes (74%); one complication occurred in 128 episodes (57%), two in 57 (26%), three in 18 (8%), four in 13 (6%), five in three (1%), and six or more in three (1%), The complications were as follows: cardiac, 100 occurrences; neurological, 72; septic, 46; associated with medical treatment, 41; renal, 27; extracranial systemic arterial embolism, 16; septic pulmonary embolism, 26; complications related to surgical treatment, 11; acute prosthetic heart valve insufficiency, six; splenic infarction or abscess, three; cardiac rhythm disturbances, three; and other, 19. The distribution of the complications relative to outcome of the patients revealed that fatality exceeded survival rates for neurologic and septic complications.
Conclusions.—
Complications may be common in patients with infective endocarditis. Cardiac complications were the most common ones, but fatality rates were higher for neurologic and septic complications. Hence, heart failure was replaced by neurologic and septic complications as the leading causes of death in patients with infective endocarditis.
(Arch Intern Med. 1992;152:2428-2432)
Author Affiliations
From the Heart Institute, Sao Paulo (Brazil) University Medical School.
Footnotes
Accepted for publication March 2, 1992.
Reprint requests to Instituto do Coracao, Hospital das Clinicas, Faculdade de Medicina da Universidade de Sao Paulo, Divisao de Clinica, Av Dr Eneas de Carvalho Aguiar, 44, 05403-000 Sao Paulo, Brazil (Dr Mansur).
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati  Twitter
What's this?
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
The Case for Infectious Endocarditis Prophylaxis: Time to Move Forward
Seto
Arch Intern Med 2007;167:327-330.
FULL TEXT
Comparison of clinical and morphological characteristics of Staphylococcus aureus endocarditis with endocarditis caused by other pathogens
Nadji et al.
Heart 2005;91:932-937.
ABSTRACT
| FULL TEXT
Infective Endocarditis: Diagnosis, Antimicrobial Therapy, and Management of Complications: A Statement for Healthcare Professionals From the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young, and the Councils on Clinical Cardiology, Stroke, and Cardiovascular Surgery and Anesthesia, American Heart Association: Endorsed by the Infectious Diseases Society of America
Baddour et al.
Circulation 2005;111:e394-e434.
ABSTRACT
| FULL TEXT
Stroke location, characterization, severity, and outcome in mitral vs aortic valve endocarditis
Anderson et al.
Neurology 2003;61:1341-1346.
ABSTRACT
| FULL TEXT
Osteoarticular Infection Complicating Enterococcal Endocarditis
Vlahakis et al.
Mayo Clin Proc. 2003;78:623-628.
ABSTRACT
Diagnosis and Management of Infective Endocarditis and Its Complications
Bayer et al.
Circulation 1998;98:2936-2948.
FULL TEXT
Clinical and morphological characteristics in Streptococcus bovis endocarditis: a comparison with other causative microorganisms in 177 cases
Kupferwasser et al.
Heart 1998;80:276-280.
ABSTRACT
| FULL TEXT
Staphylococcus aureus Endocarditis at a Community Teaching Hospital, 1980 to 1991: An Analysis of 106 Cases
Watanakunakorn
Arch Intern Med 1994;154:2330-2335.
ABSTRACT
Complications of Infective Endocarditis in the 1980s
Anand
Arch Intern Med 1993;153:1015-1015.
ABSTRACT
Complications of Infective Endocarditis in the 1980s-Reply
Mansur et al.
Arch Intern Med 1993;153:1015-1017.
ABSTRACT
|
