Infective endocarditis in patients with chronic hepatic failure: a four cases series

Infective endocarditis and liver cirrhosis is an infrequent association. A retrospective study was performed in order to characterize predisposing factors, microbial causes and evolution. Medical records between 1995 and 2008 (June) were searched. Four cases were identified. In three cases liver cirrhosis was in stage Child A, and in all 4 there was a predisposing cardiac disease. Clinical manifestations were classical in 3 cases and in one presented as hepatic failure. Only in one case a typical agent was recovered. Other cases were associated to a nosocomial agent or Corynebacterium sp. [corrected] and in one no agent was identified. One patient required valve replacement. Three patients recovered satisfactorily, all of them in Child A stage. One died of non-infectious causes (Child C). Infective endocarditis and liver cirrhosis is an infrequent association in clinical practice, it can be associated to unusual agents or clinical manifestations.