Clinical and epidemiological characteristics of infective endocarditis

OBJECTIVES
We evaluated the clinical and laboratory characteristics of patients with infective endocarditis (IE).

STUDY DESIGN
During a five-year period (January 2002-December 2006), 96 patients (56 men, 40 women; mean age 47±15 years; range 16 to 81 years) were treated and followed for IE. All the patients underwent transthoracic and transesophageal echocardiography. Clinical and laboratory characteristics of the patients were reviewed. All cases of prosthetic valve endocarditis were late-onset IE. Blood samples were cultured in both aerobic and anaerobic media and incubated for 21 days. The diagnosis of IE was made according to the Duke criteria.

RESULTS
Male-to-female ratio was 1.4. The most common complaint on presentation was dyspnea (n=58, 60.4%), followed by fever (n=20, 20.8%), and fatigue (n=16, 16.7%). The mean follow-up period was 21±12 days (range 2 to 52 days). While transthoracic echocardiography was sufficient to detect vegetations in 69 patients (71.9%), IE lesions could be demonstrated by transesophageal echocardiography in 27 patients (28.1%). The most common involvement was seen in the mitral valve (54.2%), and the incidence of native valve involvement (79.2%) was greater than that of prosthetic valve involvement. Forty-nine patients (51%) were submitted to surgery. In-hospital mortality occurred in 12 patients (12.5%). The prevalence of IE among all patients hospitalized in cardiology department was 0.13%. The culprit microorganism was isolated in only 36 patients (37.5%), being staphylococci (33.3%), enterococci (27.8%), brucellae (22.2%), and streptococci (11.1%).

CONCLUSION
The diagnosis and treatment of IE should be designed taking into consideration that epidemiologic and clinical features of IE may differ from those of individual countries.