Complications

Valvular destruction frequency is greater than that associated with viridans streptococcal endocarditis, but less than the destruction that occurs with enterococcal, streptococcal, or gramnegative aerobic bacteria (34,35). Other complications with anaerobic endocarditis include multiple mycotic aneurysms (36), aortic ring abscess and aortitis (37,38), cardiogenic shock, dysrhythmias, and septic shock.

The mortality rate for patients with anaerobes endocarditis is 21% to 43% (1,20). Endocarditis by B. fragilis or Fusobacterium necrophorum has been associated with the highest mortality—46% and 75%, respectively (1,12). F. necrophorum has been associated with acute endocarditis, rapid valve destruction, and death (12). Patients with endocarditis caused by Peptostreptococcus spp. or drug addicts with anaerobic endocarditis have a more favorable prognosis than those with endocarditis due to the B. fragilis group or Fusobacterium (39).

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