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Abstract
To characterize the patient population and clinical features of recurrent infective
endocarditis, 117 patients with 142 episodes of infective endocarditis were investigated.
Sixty-one (52 per cent) of the total population were drug abusers. Of the 96 who survived
the initial episode of infective endocarditis, 58, including 34 drug abusers, were
followed for a mean duration of 128 weeks. Recurrent infective endocarditis occurred
in 18 of 58 (31 per cent); 14 of 34 (41 per cent) of drug abusers versus four of 24
(17 per cent) of nondrug users (P < 0.05). In addition to drug abuse, prior heart
disease and periodontitis were each related (P < 0.05) to recurrence. Patients with
⪰ two risk factors for endocarditis were more likely (P < 0.05) to have a recurrence
than those with only one risk factor. Causative organism and site of infection were
similar with initial and recurrent infections. Although congestive heart failure complicating
aortic and mitral valve infections occurred more frequently in recurrent versus initial
infection (15 of 15 versus 43 of 72; P < 0.05), systemic emboli were documented with
similar frequency (P > 0.05). Excluding debilitated patients, mortality was greater
in those with recurrent versus initial infections (six of 24 versus nine of 96; P
< 0.05). Each of three habitual drug abusers who survived insertion of a valvular
prosthesis for the initial infection had a recurrence versus none of eight nondrug
abusers with prosthetic valves (P < 0.05). Thus, recurrent endocarditis is a commonly
encountered and often grave complication of infective endocarditis, particularly among
chronic drug abusers.
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Article Info
Publication History
Accepted:
January 8,
1979
Footnotes
☆This study was presented in part at the 51st Scientific Sessions of the American Heart Association, Dallas, Texas, November 15, 1978. It was supported in part by the National Heart, Lung and Blood Vessel Research and Demonstration Center, Baylor College of Medicine, NHLBI, HL -17269.
Identification
Copyright
© 1979 Published by Elsevier Inc.
