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Richard G. Norenberg
Gulshan K. Sethi
Stewart M. Scott
Timothy Takaro
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Ann Thorac Surg 1975;19:592-604
© 1975 The Society of Thoracic Surgeons

Articles

Opportunistic Endocarditis Following Open-Heart Surgery

Richard G. Norenberg, M.D., Gulshan K. Sethi, M.D., Stewart M. Scott, M.D., Timothy Takaro, M.D.*

Division of Thoracic and Cardiovascular Surgery, Veterans Administration Hospital, Oteen, N.C

* Address reprint requests to Dr. Takaro, Veterans Administration Hospital, Oteen, N.C. 28805

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.




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