"Modern" Infective Endocarditis

A LARGE number of infectious diseases have undergone remarkable changes in their natural history since the introduction of penicillin into clinical medicine 30 years ago. The duration of illness, incidence of complications, and fatality rates have been altered strikingly in those disorders for which penicillin has been effective. An outstanding example of this phenomenon is infective endocarditis. However, it is noteworthy that not all the changes in this disease have been related to therapy, and that a number of features unheard of years ago, now often characterize the etiology, clinical course, and prognosis of this type of disease. This is a brief review of the clinical, microbiological, and therapeutic features of infective endocarditis in the prepenicillin era and in the present. ETIOLOGY A great variety of microbial genera and species are the etiologic agents of infective endocarditis. In the prepenicillin era, green pigment-producing streptococci (Streptococcus viridans) were involved in about