Bacterial endocarditis at a small community hospital.

Clinical features, microbiology, and predisposing factors are described in 56 patients with bacterial endocarditis (BE) treated over a 12-year period at a small community hospital in Hawaii. The average age of patients was 52.0 years. The mean duration of symptoms was 28.8 days (range 1 to 240 days). Streptococci was the most frequently identified causative organism, present in 61% of the cases. Gram-negative bacilli were isolated from six patients (11%). Fourteen patients (25%) required cardiac surgery; the most common condition leading to surgery was severe valvular insufficiency, followed by congestive heart failure and recurrent embolism. Eighty-two percent of the patients in the series survived. The leading causes of death were congestive heart failure and cerebrovascular accidents.