Infective endocarditis in Portugal: another piece added to the puzzle

Abstract

The reported low incidence of infective endocarditis (IE) ranging between 3 and 10 per 100 000 people is probably underestimated, as a diagnosis is often challenging. A temporal increase has been documented in some European countries such as United Kingdom (UK), Germany or Denmark. Recently, an analysis on IE in the Portuguese population over the last decade identified a similar trend. An aging population, an increasing rate of valve prosthesis and intracardiac device carriers, as well as the survival to adulthood of children with congenital heart disease all contribute to explaining the noted trends. Concomitantly, the extraordinary evolution in the imaging and microbiologic medical adjuvant techniques improve diagnostic ability in a clinical setting. Medical progress can also be a drawback, with an increasing rate of invasive medical procedures. Additionally, the impact of antibiotic prophylaxis restrictions defended by scientific guidelines since 2007 and 2009 on IE incidence is unclear.