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Prosthetic Valve Endocarditis

WALTER R. WILSON, M.D.; PIERRE M. JAUMIN, M.D.; GORDON K. DANIELSON, M.D.; EMILIO R. GIULIANI, M.D., F.A.C.P.; JOHN A. WASHINGTON II, M.D., F.A.C.P.; and JOSEPH E. GERACI, M.D.
[+] Article and Author Information

▸Requests for reprints should be addressed to Walter R. Wilson, M.D., c/o Section of Publications, Mayo Clinic, 200 First St. SW, Rochester, MN 55901.


Rochester, Minnesota


Ann Intern Med. 1975;82(6):751-756. doi:10.7326/0003-4819-82-6-751
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From January 1963 until January 1974, 45 patients had prosthetic valve endocarditis. Symptoms of prosthetic valve endocarditis developed within 2 months after operation (early onset) in 16 patients (36%) and more than 2 months after operation (late onset) in 29 patients (64%). Overall mortality among the 45 patients was 56% (88% among those with early onset and 40% among those with late onset). Medical therapy alone was curative in 60% of the surviving patients. Combined medical and surgical therapy was curative in 40% of the survivors. The most frequent isolates in the early-onset group were Staphylococcus aureus (44%) and Gram-negative bacilli (38%); associated mortality was 86% and 83%, respectively. The most frequent isolates in the late-onset group were viridans streptococci (41%) and Gram-negative bacilli (31%); the mortality was 25% and 22%, respectively. Suggestions are offered for operative antimicrobial prophylaxis and for medical and surgical treatment of prosthetic valve endocarditis. Prompt surgical replacement of an infected prosthesis is necessary when medical therapy fails.

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