Infective endocarditis due to Staphylococcus aureus: 59 prospectively identified cases with follow-up.

Journal Article

Fifty-nine consecutive patients with definite Staphylococcus aureus infective endocarditis (IE) by the Duke criteria were prospectively identified at our hospital over a 3-year period. Twenty-seven (45.8%) of the 59 patients had hospital-acquired S. aureus bacteremia. The presumed source of infection was an intravascular device in 50.8% of patients. Transthoracic echocardiography (TTE) revealed evidence of IE in 20 patients (33.9%), whereas transesophageal echocardiography (TEE) revealed evidence of IE in 48 patients (81.4%). The outcome for patients was strongly associated with echocardiographic findings: 13 (68.4%) of 19 patients with vegetations visualized by TTE had an embolic event or died of their infection vs. five (16.7%) of 30 patients whose vegetations were visualized only by TEE (P < .01). Most patients with S. aureus IE developed their infection as a consequence of a nosocomial or intravascular device-related infection. TEE established the diagnosis of S. aureus IE in many instances when TTE was nondiagnostic. Visualization of vegetations by TTE may provide prognostic information for patients with S. aureus IE.

Full Text

Duke Authors

Cited Authors

  • Fowler, VG; Sanders, LL; Kong, LK; McClelland, RS; Gottlieb, GS; Li, J; Ryan, T; Sexton, DJ; Roussakis, G; Harrell, LJ; Corey, GR

Published Date

  • January 1999

Published In

Volume / Issue

  • 28 / 1

Start / End Page

  • 106 - 114

PubMed ID

  • 10028079

International Standard Serial Number (ISSN)

  • 1058-4838

Digital Object Identifier (DOI)

  • 10.1086/515076

Language

  • eng

Conference Location

  • United States