ABSTRACT
Since Osler’s comprehensive description of infective endocarditis (IE) in the 1880s, this disease has continuously evolved in respect to its epidemiology, clinical presentations, and therapy.
Over the last 30 years, greater numbers of patients with IE are being cared for in critical care units (CrCU) mainly because of the increased incidence of acute staphylococcal IE. In recent series, approximately 60% of cases of IE are caused by Staphylococcus aureus (1). By prolonging the lives of those with acute IE, antibiotics are contributing to the increasing number of cardiac and extracardiac complications of this type of valvular infection. Even in subacute IE, antibiotics have failed to lessen the frequency of embolic complications including mycotic aneurysms (2). This is due to the delay in diagnosis that has not lessened over the last 30 years. The average interval between the onset of valvular infections and diagnosis remains six weeks (3). Although complications of IE affect the heart most frequently, neurological events and sepsis are the most frequent causes of death.
