Epidemiological, Clinical, and Microbiological Features
Clinical and epidemiological aspects from the 167 patients who fulfilled
the Duke’s criteria are described in Table 1. The median age was 60
years (Q1-Q3 50-71), and 66% were male.
Previous structural heart disease was present in 34%, and 31% of
patients had already been submitted to a cardiac surgery. The most
prevalent comorbidities were arterial hypertension (56%), diabetes
mellitus (29%), chronic kidney disease (21%), previous stroke (12%),
chronic liver disease (6.6%), and chronic obstructive pulmonary disease
(6%).
The median time from symptoms onset to hospital admission was 7
(Q1-Q3 3-10) days, and from hospital
admission to definitive diagnosis 4
(Q1-Q3 1-7) days.
Fever was the most incident symptom at the time of hospital admission
(84.3%), followed by decompensated heart failure (25.7%), and a new
cerebral or peripheral embolic event (18% and 21%, respectively). New
cardiac murmur was observed in 39.5% of the cases (Table 2).
Echocardiographic evaluation demonstrated the presence of one or more
vegetations in 90.4%, and abscess in 9.6%. The valve most frequently
compromised was the aortic valve (54.5%), and the majority of the cases
involved native valves (73%) (Table 3).
A specific infective agent was identified in 76.6% of cases, with
Staphylococcus aureus (19%), Enterococcus (12%),
Coagulase- negative staphylococci (10.2%), and Viridans
streptococci (9.6%) being the most microbiological agents (Table 4).