Prosthetic valve endocarditis.

Prosthetic valve endocarditis occurs in 2-4% of patients with prosthetic valves and carries a mortality of around 50%. A low index of suspicion should enable early diagnosis. The empirical use of antibiotics in patients with a prosthetic valve who develop an unexplained fever is inappropriate. Careful liaison between cardiologist, microbiologist and cardiac surgeon is essential for optimal management.