Characteristics and treatment of Staphylococcus aureus endocarditis

In order to evaluate whether there were changes of the clinical features of Staphylococcus (Staph.) aureus endocarditis in recent years, the data of 21 cases of Staph. aureus endocarditis diagnosed from 1977 to 1994 were analyzed and compared with those of 11 cases of Staph. aureus endocarditis from 1957 to 1977. The results showed the following changes in recent years. The incidence of Staph. aureus endocarditis cases has been increasing. Cases of right-sided endocarditis increased in the recent two decades and this increase was related to intravenous drug abuse and increased use of vascular intervention. Right-sided endocarditis was different from left-sided endocarditis in their risk factors, underlying heart diseases, clinical manifestations and prognosis. The clinical manifestations of ventricular-wall endocarditis were atypical and it could be definitely diagnosed only with echocardiogram. Complications of Staph. aureus endocarditis became more common and serious, in recent decades but hospital mortality decreased markedly due to effective antibiotic management. The authors believe that sound knowledge of Staph. aureus endocarditis is essential for the proper diagnosis and treatment of Staph. aureus endocarditis.