Clinical Presentation, Etiology, and Outcome of Infective Endocarditis in the 21st Century

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Abstract
Infective endocarditis (IE) is a disease characterized by high morbidity and mortality. Although first described in the mid-16th century, the Gulstonian lectures by Osler1-3 to the Royal College of Physicians in 1885 created the impetus for the systematic study of IE. Beginning in the early 1900s, investigators have frequently reported on the manifestations of this disease.4-11 However, despite advances during the past century in diagnosis,12 medical therapy,13 and surgical treatment,14,15 mortality rates have not changed substantially in the past 25 years.5,9,16-18 The current in-hospital mortality rate for patients with IE is 15% to 20%,5,16 with 1-year mortality approaching 40%.16,18,19 This is in stark contrast to sustained and ongoing improvements observed in other cardiovascular diseases such as myocardial infarction.20