The records of 268 patients with bacteriologically confirmed endocarditis who were hospitalized between 1944 and 1967 showed 251 with one episode each and 17 with more than one episode. Of the latter group 14 had two episodes and 3 patients had three episodes each. These patients differed from those with single episodes in the following respects: α-hemolytic streptococcal endocarditis was significantly more frequent, congenital heart disease was significantly more common, and patients with multiple episodes were younger at the time of initial infection. A cure was achieved in 33 of the 37 multiple episodes (89%), which compares favorably with results in patients with single episodes. Relapse occurred in the other four episodes, but cure was achieved on retreatment.
Levison ME, Kaye D, Mandell GL, Hook EW. Characteristics of Patients With Multiple Episodes of Bacterial Endocarditis. JAMA. 1970;211(8):1355–1357. doi:10.1001/jama.1970.03170080043009
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