[Infective endocarditis: clinical analysis of 57 cases].

Background: Infective endocarditis (IE) has been an important diagnostic and therapeutic problem, often diagnosed too late. The aim of this study was to analyze the symptoms, etiologic factors and treatment of IE, and to compare them among patients treated conservatively, qualified for surgical treatment, and those who died of IE. Material and methods: 75 patients, aged 18–81 (median 52), hospitalized due to IE between 1988 and 2002 were included in this analysis. There were three groups of patients selected: group I — patients qualified for surgical treatment (n = 14), group II — deceased patients (n = 12), group III — patients treated conservatively (n = 49). Data from patient history, physical examination, laboratory findings, and treatment were analyzed. Blood cultures and echocardiography were used in diagnosing IE. Results: Blood cultures were positive in 47 (62,7%) patients, and negative in 28 (37.3%). The most frequent etiologic factors were Streptococcus sp., and further Staphylococcus sp., and Enterococcus sp. Negative blood cultures in 9 (64.3%) patients qualified for surgical treatment were significantly more frequent compared to 16 (32.7%) patients treated only conservatively. In 53 (70.7%) patients the echocardiography showed vegetations, in 17 (22.6%) other abnormalities indicating IE, and in 5 (6.7%) the echocardiography did not confirm IE. IE was present in 31 (41.3%) patients with a valvular heart disease diagnosed earlier. In 32 (42.7%) IE affected the aortic valve, in 29 (38.7%) the mitral valve, and in 5 (6.7%) both valves. In 9 patients (12.0%) IE affected prosthetic valves. IE affecting the natural aortic valves was more frequent in patients qualified for surgical treatment than in patients treated conservatively (p < 0.05). Inflammatory damage was more frequent in patients qualified for surgical treatment (11 patients, 78.6%, p < 0.003) and deceased individuals (7 patients,