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Hépato-Gastro & Oncologie Digestive

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Bacterial endocarditis and cirrhosis: epidemiology, clinical data and pronostics factors Volume 23, issue 1, Janvier 2016

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Authors
1 CHU de Caen,
service d’hépato-gastro-entérologie,
Avenue Côte de Nacre,
Caen,
France
2 CH Laennec-GHPSO,
service d’hépato-gastro-entérologie,
Creil,
France
3 CHU d’Amiens,
service de Santé Publique,
Amiens,
France
* Tirés à part.

Cirrhotic patients are prone to develop bacterial infections. In cirrhosis, bacterial infections increase mortality 4-fold as compared with general population. Few data are available about bacterial endocarditis (BE) in cirrhotic patients. Cirrhotic patients with BE are usually men, older than 55 years old with alcoholic cirrhosis and cardiopathy history. BE is more often localized on aortic valve and the most common bacteria observed are Gram positive bacteria in 74-100% of cases with about 26-80% of Staphylococcus aureus, mostly due to nosocomial infections. Enterococci and Gram negative bacteria are observed respectively in 6-19% and 3-5% of cases. Valve replacement is less performed in case of cirrhosis and associated with higher mortality. Surgical treatment could be proposed for some elected patients who need to be determined. Mortality rate is high between 50 and 80% and associated with the severity of the liver disease. Staphylococcus aureus, TP ≤40%, ascite, renal failure and nosocomial infections are determinant of poor prognosis and associated with high risk of death.