Clinical characteristics and evolution of recurrent infectious endocarditis in non drug addicts

Introduction and objectives. Recurrence of infection is observed in a high proportion of patients who have had infective endocarditis in the past. The aim of our study was to evaluate the possible differences between the firs t and the recurrent episodes of endocarditis, as well as to assess the outc ome and prognosis of patients with recurrent endocarditis. Patients and method. We reviewed a series of 13 episodes of recurrent endoc arditis from among 196 cases of infective endocarditis involving non-drug-a ddict patients in two hospitals from 1987 to 2000. Results. There were no differences between recurrent and first episodes of endocarditis according to age, sex, heart valve involved or causal microorg anisms. Prosthetic valve endocarditis was more common in patients with recu rrent endocarditis (86% versus 27%; p < 0.001). Although there were no diff erences in the rate of complications or early surgery, overall mortality wa s significantly higher in patients with recurrent endocarditis (53% versus 27%: p < 0.05). When early and late mortality were analysed separately, the differences did not achieve significance. Conclusions. Recurrent endocarditis was frequent in our series (7% of all c ases). The features were similar to those of the first episode except for a higher rate of prosthetic valve endocarditis and a higher overall mortalit y.