A retrospective review of 228 episodes of infective endocarditis where rheumatic valvular disease is still common

Two hundred and twenty-eight episodes of infective endocarditis in adult pa tients (mean age 36 years) were reviewed retrospectively. There were 183 ep isodes (80%) of native valve, 15 (7%) early prosthetic valve and 30 (13%) l ate prosthetic valve endocarditis. The most common predisposing factor was rheumatic valvular disease (65%). None of the patients were intravenous dru g users. According to the Duke criteria, the number of definite, probable a nd rejected episodes were 121 (53%,), 94 (41%) and 13 (6%), respectively. A dditional minor criteria increased the number of definite endocarditis to 8 2%. The Duke criteria are not primarily intended to influence treatment dec isions but are helpful in standardising research activities. The choice of the level of sensitivity or specificity of the criteria may be adjusted acc ording to the aim of the study and prevalence of disease in a particular ar ea. More sensitive criteria may be valuable in those countries where the pr evalence of rheumatic valvular disease is still high. (C) 2001 Elsevier Sci ence B.V. and International Society of Chemotherapy. All rights reserved.