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Factors associated with poor outcome in right heart endocarditis


We studied factors associated with poor outcome in right heart endocarditis.


In the period January 2011 – December 2012 at the National Institute for Infectious Diseases “Prof. Dr. Matei Balş” were admitted 53 patients with right endocarditis, with 72 episodes.


Males predominated (64.2%), patients in the age group 20-39 years (83%), those from urban areas (81%) and unemployed persons (69.8%). The infection was localized to the tricuspid valves – 42 cases, tricuspid valves plus left heart – 6 cases, right atrial wall – 3 cases, pulmonary valve – 1 case, right atrial device – 1 case. The main risk factor for right endocarditis was as IV drug use (86.8%). 87% of patients had HCV infection and 52.2% were HIV infected. Blood cultures were positive in 73.6% of cases. Staphylococcus aureus was the most frequently isolated (73.7%), type MSSA in 51.3% of cases.

Under treatment with antibiotics, anticoagulants, diuretics evolution was towards improvement in 52.8% of cases and 18.9% for death.

Factors associated with risk of poor outcome were: the presence of tricuspid murmurs (from 8/10 deaths vs. 13/43 survivors, p=0.003; OR=9.231, 95%CI: 1.719-49.55), the occurrence of embolic complications (4/10 deaths vs. 5/43 survivors, p=0.03; OR=5.067, 95%CI: 1.052-24.39), the presence of multiple pulmonary microabscesses (8/10 patients vs. 14/43, p=0.004; OR=8.286, 95%CI: 1.551-44.26), tricuspid vegetations larger than 10 mm (7/10 deaths vs. 5/43 survivors, p=0.0002; OR=17.73, 95%CI: 3.431-91.66), the association of HIV infection with elevated HIV-RNA and severe immune deficiency with CD4 below 200 cells/cmm.

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Correspondence to Mihaela Lavinia Zamfira.

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This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Zamfira, M.L., Benea, Ș., Andrei, C. et al. Factors associated with poor outcome in right heart endocarditis. BMC Infect Dis 13 (Suppl 1), P108 (2013).

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