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Editorial
April 16, 2003

Risk Stratification and Bedside Prognostication in Infective Endocarditis

Author Affiliations

Author Affiliations: Department of Medicine, Baystate Medical Center and Tufts University School of Medicine, Springfield, Mass.

JAMA. 2003;289(15):1991-1993. doi:10.1001/jama.289.15.1991

Before the advent of antibiotics, infective endocarditis was almost always fatal. With the introduction of penicillin in 1941, endocarditis became a treatable disease. However, many patients still died, predominantly of congestive heart failure resulting from valve destruction.1

In 1960, Kay et al2 successfully performed tricuspid valve debridement and closure of a ventricular septal defect in a patient with active Candida endocarditis. For patients with endocarditis, cardiac valve replacement surgery was initially performed to replace damaged valves only after the successful eradication of infection. In 1965, Wallace et al3 described a patient with active endocarditis who failed to respond to antibiotics alone but was cured by the combination of valve replacement and antibiotics.

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