%0 Journal Article
%T Mural Endocarditis: The GAMES Registry Series and Review of the Literature.
%A Gutiérrez-Villanueva A
%A Muñoz P
%A Delgado-Montero A
%A Olmedo-Samperio M
%A de Alarcón A
%A Gutiérrez-Carretero E
%A Zarauza J
%A García I Pares D
%A Goenaga MÁ
%A Ojeda-Burgos G
%A Goikoetxea-Agirre AJ
%A Reguera-Iglesias JM
%A Ramos A
%A Fernández-Cruz A
%A  
%J Infect Dis Ther
%V 10
%N 4
%D Dec 2021
%M 34312819
%F 6.119
%R 10.1007/s40121-021-00490-y
%X <B>BACKGROUND: </B>Mural infective endocarditis (MIE) is a rare type of endovascular infection. We present a comprehensive series of patients with mural endocarditis.<BR><B>METHODS: </B>Patients with infectious endocarditis (IE) from 35 Spanish hospitals were prospectively included in the GAMES registry between 2008 and 2017. MIEs were compared to non-MIEs. We also performed a literature search for cases of MIE published between 1979 and 2019 and compared them to the GAMEs series.<BR><B>RESULTS: </B>Twenty-seven MIEs out of 3676 IEs were included. When compared to valvular IE (VIE) or device-associated IE (DIE), patients with MIE were younger (median age 59 years, p < 0.01). Transplantation (18.5% versus 1.6% VIE and 2% DIE, p < 0.01), hemodialysis (18.5% versus 4.3% VIE and 4.4% DIE, p = 0.006), catheter source (59.3% versus 9.7% VIE and 8.8% DIE, p < 0.01) and Candida etiology (22.2% versus 2% DIE and 1.2% VIE, p < 0.01) were more common in MIE, whereas the Charlson Index was lower (4 versus 5 in non-MIE, p = 0.006). Mortality was similar. MIE from the literature shared many characteristics with MIE from GAMES, although patients were younger (45 years vs. 56 years, p < 0.001), the Charlson Index was lower (1.3 vs. 4.3, p = 0.0001), catheter source was less common (13.9% vs. 59.3%) and there were more IVDUs (25% vs. 3.7%). S. aureus was the most frequent microorganism (50%, p = 0.035). Systemic complications were more common but mortality was similar.<BR><B>CONCLUSIONS: </B>MIE is a rare entity. It is often a complication of catheter use, particularly in immunocompromised and hemodialysis patients. Fungal etiology is common. Mortality is similar to other IEs.