SPECIAL SECTION: LETTER TO THE EDITOR
Embolic complications in streptococcus viridans endocarditis
Ishak A. Mansi, MD
Associate Professor of Medicine, Louisiana State University Health Sciences Center, Department of Medicine, Section of General Internal Medicine, School of Medicine in Shreveport, 1501 Kings Highway, Shreveport, LA, USA 71130
Imansi{at}lsuhsc.edu
In their editorial, entitled "Toward reducing embolic complications from endocarditis," Drs. Homma and Grahame-Clarke indicated that the type of the organism may increase the likelihood of embolization and that Streptococcus viridans and Staphylococcus aureus endocarditis are associated with higher incidence of embolization (1). Though this is correct for S. aureus endocarditis, S. viridans endocarditis is not specifically associated with higher incidence of embolization (2,3). McLeod et al. (2), Cherubin et al. (3), and Utley et al. (4,5) found the highest incidence of emboli with fungus infection (60% to 100%), S. aureus (58%), and Neisseria (35%). Streptococcus species, including viridans, and enterococci had a lower risk of embolization (15% to 25%). In their editorial, Homma and Grahame-Clarke quoted De Castro et al. for higher embolization in S. viridans (6). However, De Castro et al. showed in their series that only 6 out of 22 patients with Streptococci had embolization, in contrast to 11 out of 16 patients with S. aureus endocarditis.
 |
References
|
|---|
1. Homma S, Grahame-Clarke C. Toward reducing embolic complications from endocarditis. J Am Coll Cardiol. 2003;42:781–783[Free Full Text]
2. McLeod R, Remington JS. Fungal endocarditis. Rahimtoola SH. Infective Endocarditis. New York, NY: Grune & Stratton; 1978. p. 211–289
3. Cherubin CE, Neu HC. Infective endocarditis at the Presbyterian Hospital in New York City from 1938–1967. Am J Med. 1971;51:83–96[CrossRef][Medline]
4. Utley JR, Mills J, Hutchinson JC, Edmunds LH Jr, Sanderson RG, Roe BB. Valve replacement for bacterial and fungal endocarditis: a comparative study. Circulation. 1973;48(Suppl 3):42–47
5. Utley JR, Mills J, Roe BB. The role of valve replacement in the treatment of fungal endocarditis. J Thorac Cardiovasc Surg. 1975;69:255–258[Abstract]
6. De Castro S, Magni G, Beni S, et al. Role of transthoracic and transesophageal echocardiography in predicting embolic events in patients with active infective endocarditis involving native cardiac valves. Am J Cardiol. 1997;80:1030–1034[CrossRef][Medline]
|
Top
References