Infective endocarditis: changing clinical features in a changing time

Infective endocarditis has changed its clinical features. This change is characterized by new predisposing and precipitating factors, a shift towards older age groups, a change in causative agents, and the influence of new antibiotics (which may induce more serious infections, e.g. fungal and gram-negative endocarditis). The overall prognosis is much better today, thanks to more adequate antibiotic therapy and to better and earlier surgery. Three examples of ‘modern infective endocarditis’ are presented: a new type of predisposition (thalidomide dysmelia in an adult), of induction (drug addiction and an indwelling catheter) and a new pathogenic organism (Salmonella typhimurium in an AIDS patient).