Which enterococci cause endocarditis and what are the risk factors?

Updated: Jun 10, 2021
  • Author: Susan L Fraser, MD; Chief Editor: John L Brusch, MD, FACP  more...
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Enterococci cause 5-15% of all endocarditis cases.

Enterococcal endocarditis usually occurs in older patients, particularly men.

The presentation of enterococcal endocarditis is typically subacute and infrequently associated with peripheral stigmata of endocarditis. Enterococcal endocarditis of native valves carries a relatively low short-term mortality rate.

Most cases of enterococcal endocarditis are left-sided. In two recent series of endocarditis caused by VRE, the aortic valve was involved more often than the mitral valve. [24, 25]

E faecalis causes most cases of endocarditis. Vancomycin-resistant E faecium is more likely to cause endocarditis than other VRE species, especially cases acquired nosocomially.

Risk factors for enterococcal endocarditis may include UTI or instrumentation, or occult colonic malignancy. [26, 27]

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