Skip Navigation Links.
Collapse <span class="m110 colortj mt20 fontw700">Volume 12 (2024)</span>Volume 12 (2024)
Collapse <span class="m110 colortj mt20 fontw700">Volume 11 (2023)</span>Volume 11 (2023)
Collapse <span class="m110 colortj mt20 fontw700">Volume 10 (2022)</span>Volume 10 (2022)
Collapse <span class="m110 colortj mt20 fontw700">Volume 9 (2021)</span>Volume 9 (2021)
Collapse <span class="m110 colortj mt20 fontw700">Volume 8 (2020)</span>Volume 8 (2020)
Collapse <span class="m110 colortj mt20 fontw700">Volume 7 (2019)</span>Volume 7 (2019)
Collapse <span class="m110 colortj mt20 fontw700">Volume 6 (2018)</span>Volume 6 (2018)
Collapse <span class="m110 colortj mt20 fontw700">Volume 5 (2017)</span>Volume 5 (2017)
Collapse <span class="m110 colortj mt20 fontw700">Volume 4 (2016)</span>Volume 4 (2016)
Collapse <span class="m110 colortj mt20 fontw700">Volume 3 (2015)</span>Volume 3 (2015)
Collapse <span class="m110 colortj mt20 fontw700">Volume 2 (2014)</span>Volume 2 (2014)
Collapse <span class="m110 colortj mt20 fontw700">Volume 1 (2013)</span>Volume 1 (2013)
American Journal of Medical Case Reports. 2021, 9(9), 467-478
DOI: 10.12691/AJMCR-9-9-8
Review Article

Risk Factors and Patient Profile of Infective Endocarditis by Gemella spp.

Pramod Theetha Kariyanna1, 2, Bayu Sutarjono3, Naga Pranavi Ellanti4, Apoorva Jayarangaiah5, Amog Jayarangaiah6, Sushruth Das6, Harshith Priyan Chandrakumar2 and Isabel M. McFarlane2,

1Division of Interventional Cardiology Fellow, Mount Sinai Heart, Icahn School of Medicine at Mount Sinai Morningside/Beth Israel, New York City, New York-10025

2Division of Cardiovascular Disease and Department of Internal Medicine, State University of New York, Downstate Medical Center, Brooklyn, NY 11203, USA

3Saba University School of Medicine, 27 Jackson Road, Devens, MA 01434, USA

4Department of Family Medicine, Mount Sinai Hospital, Chicago, IL 60608, USA

5Department of Internal Medicine, NYC Health and Hospitals/Jacobi Medical Center, Bronx, NY 10461, USA

6Trinity School of Medicine, 925 Woodstock Road, Roswell, GA 30075, USA

Pub. Date: May 25, 2021
Full Text PDF

Cite this paper

Pramod Theetha Kariyanna, Bayu Sutarjono, Naga Pranavi Ellanti, Apoorva Jayarangaiah, Amog Jayarangaiah, Sushruth Das, Harshith Priyan Chandrakumar and Isabel M. McFarlane. Risk Factors and Patient Profile of Infective Endocarditis by Gemella spp.. American Journal of Medical Case Reports. 2021; 9(9):467-478. doi: 10.12691/AJMCR-9-9-8

Abstract

Background. The diagnosis of infective endocarditis is difficult, especially when it involves atypical organisms. Therefore, our study identified risk factors of infective endocarditis caused by rare pathogen, Gemella spp. Methods. A systematic review was conducted to investigate characteristics of endocarditis patients infected with Gemella spp. using the search term “Gemella” and “endocarditis.” Case reports were gathered by searching Medline/Pubmed, Google Scholar, CINAHL, Cochrane CENTRAL, and Web of Science databases. 83 articles were selected for review. Results. 5 species of Gemella were identified. Typical patient affected were male between 31 and 45 years of age. On admission, patients had fever, tachycardia, and normal blood pressure. Common clinical manifestation other than fever included fatigue and weakness, chills and sweating, and nausea, vomiting, diarrhea, and weight changes. 1 in 4 reported a history of congenital heart disease, and a recent oral infection. 1 in 2 patients underwent surgical procedure. Laboratory tests revealed anemia, leukocytosis, and elevated erythrocyte sedimentation in all age groups, as well as elevated C-reactive protein in adult and geriatric populations only. Mitral and aortic valves were most commonly infected by Gemella spp.. The most common Gemella spp.-susceptible antibiotics were penicillin, vancomycin, cephalosporin, macrolide, and aminoglycosides. However, antibiotic resistance was observed against penicillin, aminoglycoside, and fluoroquinolone. Antibiotic therapy of at least 6 weeks resulted in superior clinical improvements than durations under 6 weeks. Finally, 1 in 2 patients underwent valve replacement or repair, with common complications affecting the cardiovascular, neurological, and renal systems. Finally, death occurred in 1 in 8 patients, half of which occurred post-surgical procedure, and the majority occurring equal to or greater than 1 week from admission. Conclusion. Our systematic review highlights the importance of considering rare pathogens, particularly in the presence of predisposing risk factors.

Keywords

infective endocarditis, Gemella spp, heart valve vegetations, clinical features, mortality, risk factors

Copyright

Creative CommonsThis work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References

[1]  Murdoch DR, Corey GR, Hoen B, et al, and the International Collaboration on Endocarditis-Prospective Cohort Study (ICE-PCS) Investigators. Clinical presentation, etiology, and outcome of infective endocarditis in the 21st century: the International Collaboration on Endocarditis-Prospective Cohort Study. Arch Intern Med 2009; 169: 463-73.
 
[2]  Selton-Suty C, Célard M, Le Moing V, et al, and the AEPEI Study Group. Preeminence of Staphylococcus aureus in infective endocarditis: a 1-year population-based survey. Clin Infect Dis 2012; 54: 1230-39.
 
[3]  Duval X, Delahaye F, Alla F, et al, and the AEPEI Study Group. Temporal trends in infective endocarditis in the context of prophylaxis guideline modifications: three successive population-based surveys. J Am Coll Cardiol 2012; 59: 1968-76.
 
[4]  Hoen B, Alla F, Selton-Suty C, et al, and the Association pour l’Etude et la Prévention de l’Endocardite Infectieuse (AEPEI) Study Group. Changing profile of infective endocarditis: results of a 1-year survey in France. JAMA 2002; 288: 75-81.
 
[5]  Cahill TJ, Prendergast BD. Infective endocarditis. Lancet 2016; 387: 882-93.
 
[6]  Lodise TP, McKinnon PS, Swiderski L, Ryback MJ. Outcomes analysis of delayed antibiotic treatment for hospital-acquired Staphylococcus aureus bacteremia. Clin Infect Dis 2003; 36: 1418-23.
 
[7]  Thuny F, Grisoli D, Collart F, Habib G, Raoult D. Management of infectious endocarditis: challenges and perspectives. Lancet 2012; 379: 965-75.
 
[8]  Chu VH, Cabell CH, Benjamin DK Jr, et al. Early predictors of in-hospital death in infective endocarditis. Circulation 2004; 109: 1745-49.
 
[9]  Meine TJ, Nettles RE, Anderson DJ, et al. Cardiac conduction abnormalities in endocarditis defined by the Duke criteria. Am Heart J 2001; 142: 280-85.
 
[10]  Li JS, Sexton DJ, Mick N, et al. Proposed modifications to the Duke criteria for the diagnosis of infective endocarditis. Clin Infect Dis 2000; 30: 633-38.
 
[11]  Durack DT, Kaplan EL, Bisno AL. Apparent failures of endocarditis prophylaxis: analysis of 52 cases submitted to a national registry. JAMA 1983; 250: 2318-22.
 
[12]  Habib G, Badano L, Tribouilloy C, et al. Recommendations for the practice of echocardiography in infective endocarditis. Eur J Echocardiogr 2010; 11: 202-19.
 
[13]  Brouqui P, Raoult D. Endocarditis due to rare and fastidious bacteria. Clin Microbiol Rev 2001; 177-207.
 
[14]  Agrawal N, Kariyappa M, Kolhari VB, Manjunath CN. Cauliflower-like deformation of pulmonary valve in a case of infective endocarditis by a rare organism: Gemella morbillorum. BMJ Case Rep 2014.
 
[15]  Agrawal T, Irani M, Rojas SF, et al. A rare case of infective endocarditis caused by Gemella haemolysans. Cureus 2019 Nov; 11(11): e6234.
 
[16]  Akyama K, Taniyasu N, Hirota J, et al. Recurrent aortic valve endocarditis caused by Gemella morbillorum: report of a case and review of the literature. Jpn Circ J 2001; 65: 997-1000.
 
[17]  Al Chekakie MO, Heroux A, Montpetit M, Nemeh H. Gemella morbillorum prosthetic valve endocarditis. Congest Heart Fail 2009 Nov-Dec; 15(6): 291-2.
 
[18]  Al Soub H, El-Shafie SS, Al-Khal AL, Salam AM. Gemella morbillorum endocarditis. Saudi Med J 2003 Oct; 24(10): 1135-7.
 
[19]  Al-Hujailan G, Lagace-Wiens P. Mechanical valve endocarditis caused by Gemella morbillorum. J Medical Microbiology 2007; 56: 1689-91.
 
[20]  Almaghrabi R, Halim M, Kherallah M, Sheikh A. Infective endocarditis caused by Gemella sanguinis. International Journal of Antimicrobial Agents 2009 Jun;33(2):S44.
 
[21]  Ando A, Kagihara J, Chung H, Bolger Jr DT. Native bivalvular endocarditis by Gemella haemolysans requiring venovenous extracorporeal membrane oxygenation. BMJ Case Rep 2016.
 
[22]  Avgoustidis N, Bourantas CV, Anastasiadis GP, et al. i in a patient with systemic lupus erythematosus. J Heart Valve Dis 2011 Jan; 20(1): 107-9.
 
[23]  Bell E, McCartney AC. Gemella morbillorum endocarditis in an intravenous drug abuser. J Infect 1992 Jul; 25(1): 110-2.
 
[24]  Benes J, Picha D, Kabelkova M, et al. Infective endocarditis caused by unusual gram-positive pathogens: report of 4 patients. Folia Micrbiol (Praha) 2002; 47(6): 737-41
 
[25]  Brack MJ, Avery PG, Hubner PJB, Swann RA. Gemella haemolysans: a rare and unusual cause of infective endocarditis. Postgrad Med J 1991; 67: 210.
 
[26]  Breathnach AS, Gould FK, Bain HH, Aucken HM. Gemella haemolysans endocarditis associated with a raised streptolysin-O titre. J Infect 1997 Jan; 34(1): 87-8.
 
[27]  Calopa M, Rubio F, Aguilar M, Peres J. Giant basilar aneurysm in the course of subacute bacterial endocarditis. Stroke 1990 Nov; 21(11): 1625-7.
 
[28]  Carano N, Agnetti A, Allegri V, et al. Infective endocarditis following body piercing: presentation of one case due to Gemella morbillorum and review of the literature. Med Sci Monit 2010; 16(10): CS124-8.
 
[29]  Chadha S, Chen O, Shetty V, et al.. "Kissing" vegetation in a rare case of infective endocarditis by Gemella sanguinis. Am J Med Sci 2013 Jun; 345(6): 507-8.
 
[30]  Constantinos M, Marios S. Gemella morbillorum tricuspid valve endocarditis resulting in septic pulmonary emboli in a patient with intracranial hemorrhage. Int J Cardiol 2015 Apr; 184: 769-71.
 
[31]  Czarnecki A, Ong GH, Pieroni P, et al. Gemella morbillorum septic arthritis of the knee and infective endocarditis. Am J Orthop (Belle Mead NJ) 2007 Jan; 36(1): E7-9.
 
[32]  Devuyst O, Hainaut P, Gigi J, Wauters G. Rarity and potential severity of Gemella haemolysans endocarditis. Acta Clin Belg 1993; 48(1): 52-3.
 
[33]  Elsayed S, Zhang K. Gemella bergeriae endocarditis diagnosed by sequencing of rRNA genes in heart valve tissue. J Clin Microbiology 2004 Oct; 42(10): 4897-900.
 
[34]  Emmanouilidou G, Voukelatou P, Vrettos I, et al. A case report of successful conservative treatment for infective endocarditis caused by Gemella sanguinis. Case Report in Infectious Diseases 2019; 9382395: 1-3.
 
[35]  Farmaki E, Roilides E, Darilis E, et al. Gemella morbillorum endocarditis in a child. Pediatr Infect Dis J 2000 Aug; 19(8): 751-3.
 
[36]  Fresard A, Michel VP, Rueda X, et al. Gemella haemolysans endocarditis. Clin Infect Dis 1993 Apr; 16(4): 586-7.
 
[37]  Gimigliano F, Carletti M, Carducci G, et al. Gemella morbillorum endocarditis in a child. Pediatr Infect Dis J 2005 Feb; 24(2): 190.
 
[38]  Godinho AR, Tome E, Vaz A, et al. Gemella endocarditis: an aggressive entity. Revista Poruguesa de Cardiologia. 2013 Dec; 32(12): 1027-30.
 
[39]  Gundre P, Pascal W, Abrol S, et al. Prosthetic valve endocarditis caused by Gemella sanguinis: a consequence of persistent dental infection. Am J Med Sci 2011 Jun; 341(6): 512-3.
 
[40]  Helft G, Tabone X, Metzger JP, Vacheron A. Gemella haemolysans endocarditis with colonic carcinoma. Eur J Med 1993 Jun-Jul; 2(6): 369-70.
 
[41]  Hikone M, Sakamoto N, Ota M, et al. The first case report of infective endocarditis caused by Gemella taiwanensis. Journal of Infection and Chemotherapy 2017; 23(8): 567-71.
 
[42]  Holland J, Wilson R, Cumpston N. Gemella morbillorum prosthetic valve endocarditis. N Z Mej J 1996 Sep; 109(1030): 367.
 
[43]  Hull JE. Multisystem organ failure due to Gemella morbillorum native valve endocarditis. Mil Med 2010 Nov; 175(11): 923-5.
 
[44]  Hussain K, Abubaker J, Al Deesi ZO, Ahmed R. Unreported neurological complications of Gemella bergeriae infective endocarditis. BMJ Case Rep 2014.
 
[45]  Jayananda S, Gollol-Raju NS, Fadul N. Gemella species bacteremia and stroke in an elderly patient with respiratory tract infection. Case Reports in Medicine 2017; 1098527: 1-2.
 
[46]  Kaufhold A, Franzen D, Lutticken R. Endocarditis caused by Gemella haemolysans. Infection 1989; 17(6): 385-7.
 
[47]  Kerr JR, Webb CH, McGimpsey JG, Campbell NP. Infective endocarditis due to Gemella morbillorum complicating hypertrophic obstructive cardiomyopathy. Ulster Medical Journal 1994; 63(1): 108-10.
 
[48]  Khan R, Urban C, Rubin D, Segal-Maurer S. Subacute endocarditis caused by Gemella haemolysans and a review of the literature. Scand J Infect Dis 2004; 36: 885-8.
 
[49]  Kofteridis DP, Anastasopoulos T, Panagiotakis S, et al. Endocarditis caused by Gemella morbillorum resistant to beta-lactams and aminoglycosides. Scand J Infect Dis 2006; 38(11-12): 1125-7.
 
[50]  Kolhari VB, Kumar VV, Agrawal N, Prakash SS. Gemella morbillorum endocarditis in hypertrophic cardiomyopathy: a rare organism causing a large vegetation and abscess in an uncommon setting. BMJ Case Rep 2014.
 
[51]  Kumar G, Al Ali AS, Bhatti NG Rare bacteria infecting the heart and affecting the kidney of a young child. Case Rep Nephrol Dial 2017; 7: 138-43.
 
[52]  La Scola B, Raoult D. Molecular identification of Gemella species from three patients with endocarditis. J Clin Microbiol 1998 Apr; 36(4): 866-71.
 
[53]  Li D, Zhu Z, Zheng X, et al. Gemella morbillorum endocarditis of pulmonary valve: a case report. Journal of Cardiothoracic Surgery 2017; 12(16): 1-5.
 
[54]  Liu D, Bateman T, Carr E. Endocarditis due to Gemella haemolysans in a newly diagnosed multiple myeloma patient. Journal of Community Hospital Internal Medicine Perspectives 2016; 6(32357): 1-3.
 
[55]  Logan LK, Zheng X, Shulman S. Gemella bergeriae endocarditis in a boy. Pediatric infectious disease journal 2008 Feb; 27(2): 184-6.
 
[56]  Lopez-Dupla M, Creus C, Navarro O, Raga X. Association of Gemella morbillorum endocarditis with adenomatous polyps and carcinoma of the colon: case report and review. Clin Infect Dis 1996 Feb; 22(2): 379-80.
 
[57]  Maraki S, Plevritaki A, Kofteridis D, et al. Bicuspid aortic valve endocarditis caused by Gemella sanguinis: case report and literature review. Journal of Infection and Public Health 2019; 12: 304-8.
 
[58]  Martin MJ, Wright DA, Jones AR. A case of Gemella morbillorum endocarditis. Postgrad Med J 1995 Mar; 71(833): 188.
 
[59]  Matsis PP, Easthope RN. Gemella haemolysans endocarditis. Aust N Z J Med 1994 Aug; 24(4): 417-8.
 
[60]  Morea P, Toni M, Bressan M, Stritoni P. Prosthetic valve endocarditis by Gemella haemolysans. Infection 1991; 6: 74.
 
[61]  Mosquera JD, Zabalza M, Lantero M, Blanco JR. Endocarditis due to Gemella haemolysans in a patient with hemochromatosis. Clinical Microbiology and Infection 2008 Jul; 6(10): 566-8.
 
[62]  Mugunthan M, Bhalla S, Shete V, Grover N. Gemella sanguinis: a rare cause of native valve endocarditis in a child. Medical Journal Armed Forces India 2016; 72: S84-S86.
 
[63]  Murai M, Fukumoto H, Negoro N, et al. Evidence of active endocarditis, caused by Gemella morbillorum, related to acute embolic stroke. Int J Cardiol 2006 Sep; 112(2): e17-8.
 
[64]  Nandakumar R, Raju G. Isolated tricuspid valve endocarditis in nonaddicted patients: a diagnostic challenge. Am J Med Sci 1997 Sep; 314(3): 207-12.
 
[65]  Pachirat O, Watt G, Pussadhamma B. First case of tricuspid valve endocarditis caused by Gemella bergeri. Case Reports in Medicine 2015; 704785: 1-3.
 
[66]  Palma G, Giodano R, Russolillo V, Vosa C. Percutaneous pulmonary valve implantation after endocarditis of Contegra valved conduit: a case report. Thorac Cardiovasc Surg 2011 Mar; 59(2): 123-5.
 
[67]  Purcell LK, Finley JP, Halperin SA. Gemella species endocarditis in a child. Can J Infect Dis 2001 Sep-Oct; 12(5): 317-20.
 
[68]  Raja NS, Meyers M, Parratt D, et al. Gemella haemolysans endocarditis: report of 2 cases and review of literature. Infect Dis Clin Pract 2009; 17: 335-8.
 
[69]  Ramchandani MS, Rakita RM, Freeman RV, et al. Total artificial heart as bridge to transplantation for severe culture-negative prosthetic valve endocarditis due to Gemella haemolysans. ASAIO J 2014 Jul-Aug; 60(4): 479-81.
 
[70]  Rosa RG, Rosa MD, Ascoli AM, et al. Cardiogenic shock due to Gemella morbillorum native mitral valve endocarditis. Clinical Case Reports 2015; 3(6): 342-344.
 
[71]  Rousseau-Gagnon M, Riopel J, Desjardins A, et al. Gemella sanguinis endocarditis with c-ANCA/anti-PR-3-associated immune complex necrotizing glomerulonephritis with a ‘full-house’ pattern on immunofluorescence microscopy. Clin Kidney J 2013; 6: 300-4.
 
[72]  Sadaune L, Roca F, Bordage M, et al. Benefits of a pre-treatment comprehensive geriatric assessment in a rare case of Gemella haemolysans endocarditis in an 86-year-old patient and a review of the literature. Medicina 2019; 55(292): 1-5.
 
[73]  Samuel L, Bloomfield P, Ross P. Gemella haemosylans prosthetic valve endocarditis. Postgrad Med J 1995 Mar; 71(833): 188.
 
[74]  Satake K, Ohsawa I, Koboayashi N, et al. Three cases of PR3-ANCA positive subacute endocarditis caused by attenuated bacteria (Propionibacterium, Gemella, and Bartonella) complicated with kidney injury. Mod Rheumatol 2011 Oct; 21(5): 536-4.
 
[75]  Seeburger J, Groesdonk H, Borger MA, et al. Quadruple valve replacement for acute endocarditis. J Thorac Cardiovasc Surg 2009 Jun; 137: 1564-5.
 
[76]  Shahani L. Gemella morbillorum prosthetic aortic valve endocarditis. BMJ Case Rep 2014.
 
[77]  Shinha T. Endocarditis due to Gemella morbillorum. Intern Med 2017; 56(13): 1751.
 
[78]  Shukla SK, Tak T, Hasselby RC, McCauley CS Jr, Reed KD. Second case of infective endocarditis caused by Gemella sanguinis. WMJ 2002; 101(3): 37-9.
 
[79]  Stroup JS, Bransteitter BA, Reust R. Infective endocarditis caused by Gemella species. Infectious Diseases in Clinical Practice 2007 May; 15(3): 203-5.
 
[80]  Taimur S, Madiha R, Samar F, Bushra J. Gemella morbillorum endocarditis in a patient with a bicuspid aortic valve. Hellenic J Cardiol 2010 Mar-Apr; 51(2): 183-6.
 
[81]  Terada H, Miyahara K, Sohara H, et al. Infective endocarditis caused by an indigenous bacterium (Gemella morbillorum). Intern Med 1994 Oct;33(10): 628-31.
 
[82]  Ukimura A, Nishihara S, Suwa M, et al. Prosthetic ball valve endocarditis due to Gemella species. Jpn Circ J 1998 Aug; 62(8): 626-8.
 
[83]  Ukudeeva A, Hawkins HK, Ahmad M, et al. Second fatal case of infective endocarditis caused by Gemella bergeriae. Int J of Biomed 2017; 7(1): 63-66.
 
[84]  Ural S, Yurtsever SG, Ormen B, et al. Gemella morbillorum endocarditis. Case Reports in Infectious Diseases 2014; 456471: 1-4.
 
[85]  Virgilio E, Chieco PA. Sixth case of infective endocarditis caused by Gemella bergeri. Braz J Infect Dis 2014.
 
[86]  Winkler J, Chaudhry SP, Stockwell PH. Gemella endocarditis presenting as an ST-segment-elevation myocardial infarction. Tex Heart Inst J 2016; 43(3): 258-60.
 
[87]  Yang CH, Tsai KT. Gemella sanguinis endocarditis: first case report in Taiwan and review of the literature. Journal of the Formosan Medical Association 2014; 113: 562-565.
 
[88]  Youssef D, Youssef I, Marroush TS, Sharma M. Gemella endocarditis: a case report and a review of the literature. Avicenna J Med 2019 Oct; 9(4): 164-8.
 
[89]  Zaidi SJ, Hysayni T, Collins MA. Gemella bergeri infective endocarditis: a case report and brief review of literature. Cardiology in the Young 2018; 28: 762-4.
 
[90]  Zakir RM, Al-Dehneh A, Dabu L, et al. Mitral bioprosthetic valve endocarditis caused by an unusual microorganism, Gemella morbillorum, in an intravenous drug user. J Clin Microbiology 2004 Oct; 42(10): 4893-6.
 
[91]  Zheng M, Ng OT, Two BW. Aortic and mitral valve endocarditis caused by Gemella morbillorum in a haemodialysis patient. Singapore Med J 2008 Dec; 49(12): e385-7.
 
[92]  Zingaro L, Bartoli E, Sechi LA. Post-infectious glomerulonephritis in a patient with Gemella haemolysans endocarditis. Am J Med 1999 Jan; 106(1): 125-6.
 
[93]  Kilpper-Balz R, Schleifer KH. Transfer of Streptococcus morbillorum to the genus Gemella as Gemella morbillorum comb. nov. Int J Syst Bacteriol 1988; 38: 442-3.
 
[94]  Collins MD. The Genus Gemella. The Prokaryotes, ed. 3. Dworkin M, Falkow S, Rosenber E, et al., eds. New York: Springer 2006: 511-8.
 
[95]  Hung WC, Chen HJ, Tsai JC, et al. Gemella parahaemolysans sp. nov. and Gemella taiwanensis sp. nov. isolated from human clinical specimens. Int J Syst Evol Microbiol 2014; 64: 2060-5.
 
[96]  Jaillon S, Berthenet K, Garlanda C. Sexual dimorphism in innate immunity. Clin Rev Allergy Immunol 2019; 56: 308-21.
 
[97]  Marijon E, Ou P, Celermajer DS, et al. Prevalence of rheumatic heart disease detected by echocardiographic screening. N Engl J Med 2007; 357: 470-76.
 
[98]  Correa de Sa DD, Tleyjeh IM, Anavekar NS, et al. Epidemiological trends of infective endocarditis: a population-based study in Olmsted County, Minnesota. Mayo Clin Proc 2010; 85: 422-26.
 
[99]  Correa de Sa DD, Hoke TR. The worldwide epidemiology of acute rheumatic fever and rheumatic heart disease. Clin Epidemiol 2011; 3: 67-84.
 
[100]  Pasquali SK, He X, Mohamad Z, et al. Trends in endocarditis hospitalizations at US children’s hospitals: impact of the 2007 American Heart Association Antibiotic Prophylaxis Guidelines. Am Heart J 2012; 163: 894-99.
 
[101]  Silverman ME, Upshaw CB Jr. Extracardiac manifestations of infective endocarditis and their historical descriptions. Am J Cardiol 2007; 100: 1802-07.
 
[102]  Servy A, Valeyrie-Allanore L, Alla F, et al., and the Association Pour l’Etude et la Prévention de l’Endocardite Infectieuse Study Group. Prognostic value of skin manifestations of infective endocarditis. JAMA Dermatol 2014; 150: 494-500.
 
[103]  Meine TJ, Nettles RE, Anderson DJ, et al. Cardiac conduction abnormalities in endocarditis defined by the Duke criteria. Am Heart J 2001; 142: 280-85.
 
[104]  Habib G, Lancellotti P, Antunes MJ, et al. 2015 ESC Guidelines for the management of infective endocarditis. European Heart Journal 2015; 36: 3075-123.
 
[105]  Prendergast BD, Tornos P. Surgery for infective endocarditis: who and when? Circulation 2010; 121: 1141-52.
 
[106]  Hill EE, Herijgers P, Claus P, et al. Infective endocarditis: changing epidemiology and predictors of 6-month mortality: a prospective cohort study. Eur Heart J 2007; 28: 196-203.
 
[107]  Chu VH, Cabell CH, Benjamin DK Jr, et al. Early predictors of in-hospital death in infective endocarditis. Circulation 2004; 109: 1745-49.