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Retrospective analysis of 97 patients with infective endocarditis seen over the past 8 years.

The medical records of 97 consecutive patients (101 episodes) of infective endocarditis seen from January 1979 through January 1987 were reviewed. Only 30% of the patients were over 50 years of age and the majority (69%) of infecting organisms were streptococci (mainly of the viridans group), which were similar to those reported from the West in the early antibiotic era. Pseudomonas organisms and enterococci accounted for 6% and 5%, respectively. Fungal infections were noted in 2 patients. There was a high incidence (38%) of predisposing rheumatic valvular disease; approximately half of these patients had prosthetic valve infections. Mitral valve prolapse was also an important predisposing disease (11%). One-third (34%) of the patients had febrile illness for longer than 8 weeks before the diagnosis was established. The hospital morality rate was 22%; cerebral embolism and ruptured mycotic aneurysm, congestive heart failure, and sudden death were the major causes of death. Echocardiography disclosed vegetations on the cardiac valves and preexisting lesions in 75% of the episodes. Early recognition and proper treatment should be the focus of efforts to reduce mortality from infective endocarditis.