Contemporary cohort study in adult patients with infective endocarditis

Background: Infective Endocarditis (IE) is a serious disease, with high morbidity and mortality. Few case series come from middle- income countries. Our aim is to describe a case series of patients with IE treated at a reference center in Brazil and compare data to other countries. Methods: A retros...

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Main Authors: Mariana Giorgi Barroso de Carvalho, Thatyane Veloso de Paula Amaral de Almeida, Nicolas de Albuquerque Pereira Feijóo, Rafael Quaresma Garrido, Giovanna lanini Ferraiuoli Barbosa, Wilma Félix Golebiovski, Bruno Zappa, Clara Weksler, Marcelo Goulart Correia, Cristiane da Cruz Lamas
Format: Article
Language:English
Published: Elsevier 2025-05-01
Series:Brazilian Journal of Infectious Diseases
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Online Access:http://www.sciencedirect.com/science/article/pii/S1413867025000248
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Summary:Background: Infective Endocarditis (IE) is a serious disease, with high morbidity and mortality. Few case series come from middle- income countries. Our aim is to describe a case series of patients with IE treated at a reference center in Brazil and compare data to other countries. Methods: A retrospective analysis of a prospectively implemented endocarditis database was conducted, including adult patients with definite IE, January 2006‒June 2023. A literature search and summary were done. Statistical analysis was performed using Jamovi®, version 1.2.2. Results: There were 502 episodes of IE; mean age ± SD was 48.4±17.2 years. Community-acquired IE occurred in 64.7 %. Main predispositions were rheumatic valve disease (30.7 %), prostheses (31.5 %), and congenital heart disease (13.9 %). Transthoracic and transesophageal echocardiograms were performed in 85 % and 78 %, respectively. Left-sided IE predominated. Fever occurred in 90.6 %, new murmurs in 50.7 %, and embolism in 45 %. Blood cultures were negative in 33.1 %; frequent pathogens were oral streptococci (15.6 %), Staphylococcus aureus (10.0 %), and enterococci (12.8 %). Main complications were heart failure (58 %), renal failure (32.8 %), and splenic embolization (35.2 %). Surgery was performed in 83.6 %; overall in-hospital mortality was 25 %; surgical mortality was 21.3 %. Conclusions: Blood culture negative left-sided IE predominated. The mortality rate was high but within the range of reported series. Surgery was performed frequently and patients who were operated on had lower mortality.
ISSN:1413-8670