Experience has shown that, despite vigorous antibiotic therapy, 30% of the patients with bacterial endocarditis die from the initial infection and another 42% either die later or are left with increased disability as a result of the damage superimposed on the underlying heart disease by the infection.1 The need for early diagnosis and prompt institution of potent therapy has, therefore, been stressed.
Fever of undetermined origin for more than a week in a person with an apparently organic heart murmur has become widely accepted as sufficient criterion for the clinical diagnosis of bacterial endocarditis and as an indication for starting therapy, without waiting for other more decisive clinical or laboratory evidence.1 Various antibiotic regimens have been proposed for their superiority in bacteriologically obscure and resistant cases. However, no significant improvement in the above statistics has occurred since 1948, and the need for new methods of management is evident. The
Lustgarten BP, Vogl A. STEROID THERAPY IN SEVERE BACTERIAL ENDOCARDITIS: REPORT OF A CASE. JAMA. 1959;170(7):800–805. doi:10.1001/jama.1959.63010070002010a
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