1. The microbiology and pathogenesis of infective endocarditis
- Author
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S E Young, C Clarke, C.M. Oakley, W Somerville, A. G. W. Whitfield, and Bayliss R
- Subjects
Adult ,Male ,Aortic valve ,medicine.medical_specialty ,Adolescent ,Heart Diseases ,medicine.medical_treatment ,Heart Valve Diseases ,Staphylococcal infections ,Valve replacement ,Streptococcal Infections ,medicine ,Humans ,Endocarditis ,Child ,Aged ,Genitourinary system ,business.industry ,Endocarditis, Bacterial ,Middle Aged ,Staphylococcal Infections ,medicine.disease ,Surgery ,Cardiac surgery ,medicine.anatomical_structure ,Child, Preschool ,Heart Valve Prosthesis ,Infective endocarditis ,Etiology ,Female ,Cardiology and Cardiovascular Medicine ,business ,Research Article - Abstract
Some details of 544 episodes of infective endocarditis occurring in 541 patients during 1981 and 1982 are reported. The mean age of patients was 51.6 years and there was a greater proportion of males (2:1). Of the 544 episodes 347 (63%) were due to streptococci, 19% to staphylococci, and 14% to bowel organisms. A wide variety of other organisms were responsible for a few cases, and 10% were culture negative. In 60% the portal of entry of the infection could not be ascertained: 19% were probably of dental origin: 16% arose from the alimentary, genitourinary, or respiratory tracts or from the skin or in association with drug addiction, fractures, or pregnancy; the remaining 5% were related to cardiac or other vascular surgery, cardiac catheterisation, haemodialysis, or other procedures involving the blood stream. Seventy-four (14%) of the 541 patients (mean age 59.0 years) died; the mortality was 30% in staphylococcal cases, 14% in infections due to bowel organisms, and 6% in other streptococcal infections. One hundred and seventy-one (32%) of the patients appeared to have had normal hearts before the onset of illness and another 59 (11%) had cardiac lesions not previously recognised. The aortic valve was the most common site of infection. Ninety (17%) of the patients had prosthetic valves or had undergone other cardiac surgery while 34 (6%) had had a previous episode of infective endocarditis. Nine (1.6%) episodes were not diagnosed until necropsy or operation and 34 (6.3%) required urgent valve replacement.
- Published
- 1983