Rheumatic symptoms and signs in subacute infective endocarditis.

Two hundred patients (90 men and 110 women), mean age 36.2 years, admitted to a Department of Medicine, between 1961 and 1979 with subacute infective endocarditis (SIE) were studied. Rheumatic heart valve disease was the predisposing lesion in 94% and the mitral valve was involved in about 80% of the cases. Diagnosis of SIE was confirmed by blood cultures in 66 patients and at autopsy on another 57 patients. The rheumatic symptoms and signs (RSS) considered were: arthralgia, rachialgia, arthritis, myalgia and Osler's nodes. RSS showed up in 50 (25%) of the subjects and arthralgias were the most frequent (12.5%). There were no significant differences between the 50 RSS patients and the other patients, regarding bacteriological and other laboratory data, including immunoglobulins. RSS patients were significantly younger (P less than 0.001). Out of the 200 patients, 71 (35.5%) died. Eight (16%) of these were in RSS subgroup of 50 patients. Presence of RSS did not worsen prognosis in our patients. Septic bone metastasis was not identified.