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We retrospectively reviewed the clinical characteristics and outcomes of 61 patients with 62 episodes of prosthetic valve endocarditis,paying particular attention to neurologic complications(stroke).Atypical features of the group included a benign outcome of early postoperative infection (18%mortality)and a high stroke morbidity and mortality rate with Staphylococcus epidermidis infections.Eleven patients(18%)suffered an embolic stroke,most less than or equal to 3 days after diagnosis and before the initiation of antimicrobial therapy;the rate of embolic stroke recurrence was low(9%).The risk of embolic stroke was lower with bioprosthetic than with mechanical valves.No protective effect of anticoagulation therapy with warfarin was observed.Six patients(8%) suffered brain hemorrhage due to septic arteritis,brain infarction,or undermined causes;no specific risk of hemorrhagic stroke was evident with anticoagulation therapy.Antibiotic treatment appears to be more important than anticoagulation to prevent neurologic complications in patients with prosthetic valve endocarditis. |
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antibiotic prophylaxis
antibiotics
anticoagulant,treatment
bacterial endocarditis,neurologic manifestations of
cerebral embolism
cerebral embolism,cardiac origin
cerebrovascular accident
cerebrovascular accident,recurrent
embolism
endocarditis
endocarditis,neurologic manifestations with
heart valve,prosthetic
intracerebral hemorrhage
mortality
treatment of neurologic disorder
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