Infective endocarditis at the Johannesburg Hospital. A retrospective analysis of 40 patients.

The records of 40 patients admitted to the Johannesburg Hospital with a total of 44 episodes of endocarditis were analysed. Pyrexia, albeit often low grade and intermittent, was the most consistent physical sign. The classic symptoms and signs of infective endocarditis were uncommon. Blood cultures were positive in 56% of episodes. However, in 6 out of 9 patients with 'culture-negative' endocarditis, infective endocarditis was confirmed at surgery or necropsy. For haemodynamic reasons, 10 patients (25%) were subjected to valve replacement and 1 to a mitral valvuloplasty. In 2 of these the infection was still active at the time of surgery. Five patients (12,5%) died; in 4 the cause of death was neurological and in the remaining patient the aortic valve ruptured and he died within 30 minutes.