Definite Streptococcus bovis endocarditis: characteristics in 20 patients

Objective To determine the specific characteristics of Streptococcus bovis infective endocarditis (IE) by reviewing our own experience of S, bovis IE. Methods Twenty episodes of definite S, bovis IE were reviewed in 20 patients hospitalized from 1980 to 1996. Results The mean age was 62 +/- 14 years, and 14 (70%) patients had no known predisposing cardiac condition. The principal antimicrobials used were penicillin G (N = 10) and amoxycillin (N = 8). Surgery was required in Four (20%) patients. Neurologic complications occurred in eight (40%) patients, after initiation of therapy in six (75%) (mean time: 14 days). An unfavorable outcome was observed in four of 20 patients and tended to be more frequent in patients who had had neurologic complications (P = 0.10). Colonic tumors were present in 11 of 16 (69%) patients. Conclusions Advanced age, occurrence of IE on presumably normal valves, high rate of neurologic complications, associated gastrointestinal diseases and low mortality rate during initial follow-up are characteristic features of S. bovis IE observed in this study.