Description of clinical characteristics, diagnostic criteria and management of infectious endocarditis in a tertiary hospital in Goiás

an 11-month retrospective study

Abstract

Infective endocarditis (IE) is a severe condition characterized by infection of the inner layer of the heart, particularly the heart valves, by microorganisms such as bacteria or fungi. It is essential to highlight the importance of preventing infective endocarditis, especially in atrisk patients. Objective: To analyze risk factors, diagnosis, and therapeutic approaches adopted in patients with IE admitted to a tertiary hospital in Goiás over a 11-month period. Methods: This was an observational, retrospective, and descriptive study conducted at a tertiary hospital in Goiás, reviewing medical records of patients hospitalized with infective endocarditis between May 2024 and March 2025, diagnosed according to the Modified Duke Criteria. Clinical, laboratory, electrocardiographic, radiographic, and echocardiographic data were analyzed, including vegetation characteristics and associated complications. Times to diagnosis, length of hospital stay, and, when applicable, surgery were recorded, as well as antimicrobial regimens and cardiac surgical interventions. Outcomes included hospital discharge, outpatient follow-up, or death, ensuring patient anonymity and adherence to ethical standards. Results: Among the nine patients evaluated with infective endocarditis, eight required the use of a central venous catheter during hospitalization. Transthoracic echocardiography identified vegetations in six cases, while transesophageal echocardiography was necessary in three. Most patients (7/9) were discharged, with two deaths recorded. Six presented positive blood cultures, predominantly caused by multidrug-resistant microorganisms, while three remained negative. Seven patients had vegetations larger than 10 mm, associated with higher risk of complications, and three fulfilled definitive Duke criteria. Conclusion: The study analyzed nine cases of infective endocarditis, highlighting the importance of the modified Duke criteria and complementary tests, such as echocardiography and blood cultures, for diagnostic confirmation. Prolonged antimicrobial therapy, guided by susceptibility testing, resulted in favorable clinical outcomes in most patients, although limited access to cardiac surgery delayed the correction of severe lesions in some cases. Early detection, a multidisciplinary approach, and prompt outpatient follow-up proved essential to reducing complications and recurrences.