A Long-term View of Bacterial Endocarditis

Abstract

One hundred forty one patients seen in 1950-63 were compared with 337 seen in 1924-1963. Cases due to staphylococci are new. A decrease of cases caused by Streptococcus viridans and an increase in those due to staphylococci was noted. There was an increase in cases with congential heart disease and in 4% the disease followed cardiotomy. Patients with no obvious preceding heart disease had a bad prognosis. A white blood count over 14,000/cu. mm and a hemoglobin below 12 g suggests staphylo-coccal disease. The immediate fatality rate has fallen from 97% to 26 to 30% but the late fatality rate was 51%. The patients have been analysed in relation to age, sex, type of heart disease, bacteriology, the results of blood cultures, length of the disease, heart failure, cardiac rhythm complications, drug treatment and antibiotic sensitivities in relation to prognosis. The signs and symptoms leading to early and exact diagnosis have also been discussed.