Læknablaðið - 15.05.1989, Blaðsíða 13

LÆKNABLAÐIÐ
155
SUMMARY
A retrospective analysis of all cases of infective
endocarditis in Iceland 1976-1985 was carried out. 5.
Hospital and autopsy records from all over the country
were reviewed. During the 10 year period 71 infections
in 67 patients fulfilled the set criteria, giving an 6.
incidence of 2.96/105 inhabitants/year, in a population
of 240 thousand. Most infections (30) were due to
streptococci. S. viridans was the causative organism in
14 cases and nonhemolytic streptococci in 8 cases. S.
aureus was the causative organism on 17 occasions.
Most of the infections were on the left side of the heart
and in 8 cases a prostethic valve was infected. Forty four
(62%) of the patients had an identifiable risk factor of
infective endocarditis and on two occasions, no
antibiotic prophylaxis during dental procedure in
patients with known heart disease may have contributed
to infection. On admission 34 patients (47,8%) had ten
thousand or fewer white blood cells per microliter and
15 (21.2%) had erythrocyte sedimentation rate of less
than 20 mm/hour. Echocardiogram was done on 29
patients, twenty one of them (72,4%) had positive signs
of infective endocarditis and in some instances the
diagnosis was based on the results of the
echocardiogram. In 9 patients a valve operation was
required because of the infection. Twenty four patients
(33,8%) died, and in 14 of these the diagnosis of
infective endocarditis was first made at autopsy. Of
those who died, five had been treated with appropriate
antibiotics for more than 3 days before death.
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