Infectious endocarditis without intracardiac devices or underlying structural heart disease




Abelardo Flores-Morales, Departamento Clínico de Cardiología, Unidad Médica de Alta Especialidad, Hospital de Especialidades “Dr. Bernardo Sepúlveda Gutiérrez”, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social (IMSS), Ciudad de México, México
Andrés Jacobo-Ruvalcaba, Departamento Clínico de Cardiología, Unidad Médica de Alta Especialidad, Hospital de Especialidades “Dr. Bernardo Sepúlveda Gutiérrez”, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social (IMSS), Ciudad de México, México
Ariana C. Acevedo-Meléndez, Departamento Clínico de Cardiología, Unidad Médica de Alta Especialidad, Hospital de Especialidades “Dr. Bernardo Sepúlveda Gutiérrez”, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social (IMSS), Ciudad de México, México
María J. Fernández-Muñoz, Departamento Clínico de Cardiología, Unidad Médica de Alta Especialidad, Hospital de Especialidades “Dr. Bernardo Sepúlveda Gutiérrez”, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social (IMSS), Ciudad de México, México
Héctor A. Carmona-Ruiz, Servicio de Cardiología, Hospital General de Zona con Medicina Familiar No. 1 Dr. Alfonso Mejía Schroeder, Pachuca, Hidalgo, Mexico
Gabriela Borrayo-Sánchez, Coordinación de Innovación en Salud, IMSS, Ciudad de México, México
Alberto Chaparro-Sánchez, Servicio de Infectología, Hospital de Infectología, Centro Médico Nacional La Raza, Ciudad de México. México
Óscar Orihuela-Rodríguez, Departamento Clínico de Cardiología, Unidad Médica de Alta Especialidad, Hospital de Especialidades “Dr. Bernardo Sepúlveda Gutiérrez”, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social (IMSS), Ciudad de México, México


Objective: To describe clinical, microbiological and echocardiographic aspects of endocarditis in a specific group of patients without intracardiac devices or underlying structural heart disease. Method: Retrospective study, clinical records and echocardiographic reports were reviewed during the period 1997 to 2020. Duke’s modified criteria were applied. Statistical analysis: univariate expressed in frequencies, using measures of dispersion and central tendency. Results: 30,000 echocardiographic reports were reviewed, only 1350 had infectious endocarditis as a reason for sending, of which 248 cases were selected. The mean age was 48.1 ± 16.7 years. 140 men (56%) and 108 women (44%). The most frequent echocardiographic sign was vegetation, in 278 (93.60%), and most common location was mitral (35.55%), with a higher number of cases in the right ventricle than expected. The most common systemic disease was kidney disease, in 135 (41.08%). A case of Streptococcus thoraltensis not previously reported in Mexico was identified. Conclusions: The presence of infectious endocarditis has increased due to invasive in-hospital and drug procedures. Due to their complexity, multidisciplinary teams are indispensable.



Keywords: Endocarditis. Infectious endocarditis. Vegetation.