Journal Article

Infective Endocarditis Due to <i>Staphylococcus aureus</i>: 59 Prospectively Identified Cases with Follow-up

Vance G. Fowler, Linda L. Sanders, Li Kuo Kong, R. Scott McClelland, Geoffrey S. Gottlieb, Jennifer Li, Thomas Ryan, Daniel J. Sexton, Georges Roussakis, Lizzie J. Harrell and G. Ralph Corey

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 28, issue 1, pages 106-114
Published in print January 1999 | ISSN: 1058-4838
Published online January 1999 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/515076
Infective Endocarditis Due to Staphylococcus aureus: 59 Prospectively Identified Cases with Follow-up

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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.

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Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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