The Annals of Thoracic Surgery, Vol 19, 592-604, Copyright © 1975 by The Society of Thoracic Surgeons
Opportunistic endocarditis following open-heart surgery
RG Norenberg, GK Sethi, SM Scott and T Takaro
The incidence of endocarditis following open-heart operations is declining,
but the relative incidence of endocarditis by the opportunistic organisms,
both bacterial and fungal, has increased. These "opportunists" require
careful identification and sensitivity testing so that appropriate therapy
can be planned. In cases of candida endocarditis, a positive precipitin
test and elevated candida antibody titer may provide an earlier means of
diagnosis than blood cultures. These patients should be treated promptly
with adequate dosages of specific antimicrobial or antifungal agents.
Reoperation should be considered early if there is evidence of valve
dehiscence or embolic phenomena or if drug therapy fails to control the
infection.