Infective Endocarditis and the CNS
Endocarditis can have profound and devastating neurologic consequences.
The incidence of central nervous system (CNS) complications in infective endocarditis is approximately 30% and these manifestations are often the first sign of illness (47% of the time in one series).
In most cases, the neurologic sequelae are present before the initiation of antimicrobial therapy (76%). Even amnesia can herald a diagnosis of infective endocarditis.
The Massachusetts General Hospital experience from 1964-1973 yielded 218 patients with bacterial endocarditis, 84 of whom had neurologic complications (38%).
Another series (133 patients) demonstrated a similar proportion (41%) of patients with infective endocarditis with neurologic problems.