Comparison of the clinical manifestations of infective endocarditis between elderly and young patients — a 3-year study
Tseng-Yu Huang, Hsiang-Kuang Tseng, Chang-Pan Liu, Chun-Ming Lee
Division of Infectious Disease, Department of Medicine, Mackay Memorial Hospital; Mackay Medicine Nursing Management College; and Taipei Medical University, Taipei, Taiwan
Received: May 11, 2007 Revised: August 25, 2008 Accepted: August 31, 2008
Background and purpose:
Infective endocarditis (IE) is associated with high morbidity and mortality. This study investigated the clinical manifestations and outcomes of IE and compared them between old and young patients.
In this retrospective study, data for patients with IE who were treated from November 1, 2003 to October 30, 2006 were collected. Patients were identified as having IE if they met the modified Duke criteria for definitive IE.
Seventy two patients were included. The most common symptoms were fever (81%) and dyspnea (50%). Fifty four patients (75%) had culture-positive IE. Staphylococcus aureus (35%) was the most common organism isolated, followed by Streptococcus spp. (26%). Vegetations were detected in 60 patients (83%): mitral valve (MV; 40%), aortic valve (AV; 24%), tricuspid valve (TV; 14%), MV and AV (4%), and pulmonary valve (1%). Thirty nine patients (54%) had embolic complications — 26 older patients (79%) and 13 younger patients (33%). Twenty two patients (31%) died in hospital. There were significant differences in clinical features between older and younger patients. Diabetes mellitus (p ≤ 0.01), MV vegetation (p ≤ 0.01), emboli (p ≤ 0.01), and mortality (p = 0.01) were more common among older patients, while male sex (p ≤ 0.01), intravenous drug use (p ≤ 0.01), S. aureus endocarditis (p ≤ 0.01), and TV vegetation (p = 0.01) were more common in younger patients.
While this study showed significant differences between older and younger patients, further investigation will be necessary to more precisely characterize the clinical spectrum of IE.
Aged; Endocarditis; Middle aged; Mortality; Young adult
J Microbiol Immunol Infect. 2009;42:154-159.