Managing infective endocarditis in older patients: do we need a geriatrician?

Managing infective endocarditis in older patients is of growing concern since this severe infection is increasingly frequent in this population and is responsible for high mortality and morbidity. Specific issues concerning diagnostic procedures, antibiotic therapy and cardiac surgical decisions in this patient setting are highlighted here. They indicate that infectious diseases physicians, cardiologists and cardiac surgeons should adapt their therapeutic strategy beyond the available guidelines. Recent data also showed that geriatric parameters, such as functional and nutritional status, are crucial components impacted by infective endocarditis and related to a worse outcome in older patients. Geriatricians are expert in evaluating older patients, and detecting and managing these problems. We discuss here why we consider that geriatricians should be involved in the management of these patients.