de Carvalho Mariana Giorgi Barroso, de Almeida Thatyane Veloso de Paula Amaral, Feijóo Nicolas de Albuquerque Pereira, Garrido Rafael Quaresma, Barbosa Giovanna Lanini Ferraiuoli, Golebiovski Wilma Félix, Zappa Bruno, Weksler Clara, Correia Marcelo Goulart, Lamas Cristiane da Cruz
Universidade do Grande Rio/Afya (UNIGRANRIO/Afya), Departamento de Medicina, Rio de Janeiro, RJ, Brazil; Instituto Nacional de Cardiologia, Rio de Janeiro, RJ, Brazil.
Instituto Nacional de Cardiologia, Rio de Janeiro, RJ, Brazil.
Braz J Infect Dis. 2025 May-Jun;29(3):104521. doi: 10.1016/j.bjid.2025.104521. Epub 2025 Apr 2.
Infective Endocarditis (IE) is a serious disease, with high morbidity and mortality. Few case series come from middle- income countries. Our aim is to describe a case series of patients with IE treated at a reference center in Brazil and compare data to other countries.
A retrospective analysis of a prospectively implemented endocarditis database was conducted, including adult patients with definite IE, January 2006‒June 2023. A literature search and summary were done. Statistical analysis was performed using Jamovi®, version 1.2.2.
There were 502 episodes of IE; mean age ± SD was 48.4±17.2 years. Community-acquired IE occurred in 64.7 %. Main predispositions were rheumatic valve disease (30.7 %), prostheses (31.5 %), and congenital heart disease (13.9 %). Transthoracic and transesophageal echocardiograms were performed in 85 % and 78 %, respectively. Left-sided IE predominated. Fever occurred in 90.6 %, new murmurs in 50.7 %, and embolism in 45 %. Blood cultures were negative in 33.1 %; frequent pathogens were oral streptococci (15.6 %), Staphylococcus aureus (10.0 %), and enterococci (12.8 %). Main complications were heart failure (58 %), renal failure (32.8 %), and splenic embolization (35.2 %). Surgery was performed in 83.6 %; overall in-hospital mortality was 25 %; surgical mortality was 21.3 %.
Blood culture negative left-sided IE predominated. The mortality rate was high but within the range of reported series. Surgery was performed frequently and patients who were operated on had lower mortality.
感染性心内膜炎（IE）是一种严重疾病，发病率和死亡率很高。来自中等收入国家的病例系列很少。我们的目的是描述在巴西一家参考中心接受治疗的IE患者病例系列，并将数据与其他国家进行比较。
对前瞻性建立的心内膜炎数据库进行回顾性分析，纳入2006年1月至2023年6月确诊为IE的成年患者。进行了文献检索和总结。使用Jamovi®1.2.2版进行统计分析。
共有502例IE发作；平均年龄±标准差为48.4±17.2岁。64.7%为社区获得性IE。主要易感因素为风湿性瓣膜病（30.7%）、人工瓣膜（31.5%）和先天性心脏病（13.9%）。分别有85%和78%的患者进行了经胸和经食管超声心动图检查。左侧IE占主导。90.6%的患者出现发热，50.7%出现新杂音，45%出现栓塞。33.1%的血培养结果为阴性；常见病原体为口腔链球菌（15.6%）、金黄色葡萄球菌（10.0%）和肠球菌（12.8%）。主要并发症为心力衰竭（58%）、肾衰竭（32.8%）和脾栓塞（35.2%）。83.6%的患者接受了手术；总体住院死亡率为25%；手术死亡率为21.3%。
血培养阴性的左侧IE占主导。死亡率很高，但在报道系列的范围内。手术实施频繁，接受手术的患者死亡率较低。
