Infective endocarditis in elderly patients

Abstract

Infective endocarditis (IE) is a rare disease, but it is still associated with high mortality and elderly represent a growing proportion of patients with this disease. At the moment, more than one third of the IE patients is over 70 years old in developed countries. Although mean age of patients with endocarditis is still between 40 and 50 years old in our country, it is a fact that more elderly patients with IE will be seen in the coming years because of the prolongation of the life span and the increase in the proportion of the elderly. According to the information obtained from the case series, the clinical presentation of elderly patients with IE was remarkable for a more indolent course, lower rates of embolism and smaller vegetation. Additionally IE was more frequently associated with health care and a prosthetic device among elderly patients. The leading causative organisms were either health-care associated Staphylococci or Streptococcus gallolyticus and enterococci originated from the digestive or the urinary tract. In addition, antimicrobial therapy is also difficult for elderly patients because of the higher rate of the side effects and drug interactions. In order to be able to cope with all these difficulties, elderly patients with IE should be managed by a team consisting of geriatric, cardiology and infectious diseases specialists and cardiac surgeons.