CURRENT ASPECTS OF INFECTIOUS ENDOCARDITI S - 53 CASES

Fifty-three cases of infective endocarditis are reported : 10 definite , 33 probable, 10 possible. There were : 35 males, 18 females, mean ag e 66 +/- 14 years. Twenty-three patients had a known valve involvement , 21 a recently diagnosed valve involvement, 9 a prosthetic valve. Fif ty patients had fever, 43 had a regurgitating murmur, 28 weakness and weight-loss, 13 cutaneous lesions, 11 arthritis, 8 splenomegaly, 3 ocu lar lesions. The portal of entry was suspected or confirmed in 37 case s : intestinal in 12 cases, dental in 11 cases, cutaneous in 7 cases, urinary tract infection in 6 cases, upper respiratory tract infection in 1 case. The micro-organism was found in 45 cases : 10 oral streptoc occi, 12 D bovis streptococci, 6 enterococci, 5 aureus staphylococci, 3 coagulase-negative staphylococci, 2 Coxiella burnetii, 7 other bacte rias. Blood-cultures were negative in 8 cases. Precordial echocardiogr aphy found vegetations in 27 native valves and 9 prothetic alterations . Ten patients had neurologic complications, 27 cardiac complications, 8 acute renal failure. Nine patients needed cardiac surgery, 6 died. Our results, compared with those in the litterature, showed older age, a higher frequency of digestive portal of entry and of D bovis strept ococci, frequently associated with a colic tumour.