Key messages

• Endocarditis caused by Staphylococcus aureus follows a short aggressive course, unlike the more indolent streptococcal disease.

• Underlying cardiac lesions, most frequently mitral valve prolapse, are present in 73 per cent of patients.

• Prosthetic valve endocarditis accounts for a third of all cases.

• Development of the vegetation precedes bacterial colonization.

• Alpha-hemolytic streptococci are the most common pathogens in native valve endocarditis and coagulase-negative staphylococci are the most common in prosthetic valves.

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