Bacterial endocarditis in the community hospital.

The clinical records of 66 patients with bacterial endocarditis hospitalized in three community hospitals in Saginaw, Michigan, from 1964 through 1979 were reviewed. Data from these nonreferral hospitals demonstrate that infective endocarditis often does not present to the primary care physician with classical physical findings. The etiological organisms were noted to change from being primarily alpha-hemolytic streptococci during the early part of the study to staphylococci and Streptococcus faecalis during later years. Narcotic addiction was a factor of increasing importance in the development of endocarditis and in the changing microbiology of this clinical syndrome.