MINI-SYMPOSIUM

Diagnostic criteria and problems in infective endocarditis

B D Prendergast

Correspondence to:
Correspondence to:
Dr Bernard D Prendergast
North-West Regional Cardiothoracic Centre, Wythenshawe Hospital, Southmoor Road, Manchester M23 9LT, UK; bernard.prendergast@smuht.nwest.nhs.uk

Keywords: infective endocarditis; Duke criteria; Staphylococcus aureus; Coxiella burnetti

The first 150 words of the full text of this article appear below.

Few diseases present greater difficulties in the way of diagnosis than malignant endocarditis, difficulties which in many cases are practically insurmountable. It is no disparagement to the many skilled physicians who have put their cases upon record to say that, in fully one-half the diagnosis was made post mortem.—William Osler 1885

Osler’s portentous words are as relevant now as when originally published. Despite improved preventive strategies, rational antibiotic prescribing, advances in imaging, and increasing use of early life saving cardiac surgery, the incidence of infective endocarditis remains high at 1.7–6.2 per 100 000 person years in the USA and Europe, with a one year mortality approaching 40%.¹ The classical patient with infective endocarditis described in textbooks no longer represents the majority of cases in practice. The emergence of staphylococcal infection, often associated with indwelling devices, co-existent medical conditions and resistant to conventional antibiotic regimes, a variety of other atypical . . . [Full text of this article]

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