• Javier López, José A San Román, Ana Revilla, Isidre Vilacosta, María Luaces, Cristina Sarriá, Itziar Gómez, and Francisco Fernández-Avilés.
• Servicio de Cardiología, Instituto de Ciencias del Corazón (ICICOR), Hospital Clínico Universitario, Valladolid, España.
• Rev Esp Cardiol. 2005 Feb 1; 58 (2): 153-8.

Introduction And ObjectivesPublished case series on Streptococcus viridans endocarditis are scarce and outdated. The aims of our study were multiple: to analyze the profile of the Streptococcus viridans endocarditis, to compare it with other types of left-sided endocarditis and with cases caused by Staphylococcus aureus, and to determine predictors of poor outcome in Streptococcus viridans endocarditis.Patients And MethodWe analyzed 441 episodes of endocarditis: 330 left-sided and 54 caused by Streptococcus viridans (16%). We compared the 54 cases due to Streptococcus viridans with the remaining cases of left-sided endocarditis in our series, and also with cases caused by Staphylococcus aureus. We also analyzed the predictors of death and urgent surgery in Streptococcus viridans endocarditis.ResultsLeft-sided endocarditis due to Streptococcus viridans led to a similar degree of valvular destruction, showed acute onset less frequently, and led to less renal failure, septic shock and mortality than the remaining cases of left-sided endocarditis in our series. The same differences were found in comparison to Streptococcus viridans endocarditis. Prognostic factors for Streptococcus viridans left-sided endocarditis were heart failure and periannular complications.ConclusionsAlthough Streptococcus viridans is a nonaggressive microorganism, valvular destruction is similar to that caused by other pathogens when it causes left-sided endocarditis. Nonetheless its prognosis is better, a feature which may be related to the fact that the systemic infectious syndrome can be treated more effectively. Prognostic factors in left-sided endocarditis due to Streptococcus viridans are heart failure and periannular complications.

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