{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T14:17:16Z","timestamp":1788185836475,"version":"build-2803163510"},"reference-count":17,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:00:00Z","timestamp":1788134400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:00:00Z","timestamp":1788134400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"National Hospital"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Infection"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Infective endocarditis (IE) often presents with non-specific symptoms, which may delay diagnosis and treatment. Previous studies exploring symptom duration have been limited by small cohorts or single-centre studies. We aimed to investigate patient characteristics, microbial aetiology, treatment, and all-cause mortality of patients with IE according to symptom duration prior to diagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We included all patients with first-time IE from the NatIonal Danish Endocarditis StUdies (NIDUS) registry (2016\u20132021). Patients with left-sided IE and available symptom duration were stratified as short, intermediate, or prolonged (\u2264\u20097, 8\u201329, or \u2265\u200930 days). The primary outcome was six-month mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 2,938 patients with left-sided IE, median symptom duration was 8 days [IQR:4\u201320], and 17.6% had symptoms\u2009\u2265\u200930 days. The short-duration group compared with the prolonged-duration group was older (median 74.1 vs. 72.2 years), more often female (35.1% vs. 24.8%), had more comorbidities, embolism (14.5% vs. 8.9%), sepsis (28.2% vs. 12.2%), and\n                      <jats:italic>Staphylococcus aureus<\/jats:italic>\n                      IE (38.3% vs. 11.6%). The short- and intermediate-duration groups underwent surgery less frequently (18.1% and 23.2%) than the prolonged-duration group (31.7%). The six-month cumulative incidence of mortality was lower in the prolonged-duration group (21.8%) than in the short and intermediate groups (28.7% and 28.9%), although non-significant after adjustment (HR 0.92 [95% CI:0.74\u20131.14]) compared to the short group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      In patients with left-sided IE, short symptom duration prior to diagnosis was associated with\n                      <jats:italic>Staphylococcus aureus<\/jats:italic>\n                      IE, sepsis, and lower surgical rates. Prolonged symptom duration was associated with lower cumulative mortality, but this was not significant after multivariable adjustment.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s15010-026-02960-2","type":"journal-article","created":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T13:42:14Z","timestamp":1788183734000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of time from symptom onset to diagnosis in infective endocarditis: insights from the nationwide NIDUS registry"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-6015-4497","authenticated-orcid":false,"given":"Mads-Gustav Nebel","family":"Hvidt","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amna","family":"Alhakak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter Laursen","family":"Graversen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katra","family":"Hadji-Turdeghal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob Eifer","family":"M\u00f8ller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niels Eske","family":"Bruun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kasper Karmark","family":"Iversen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonas Agerlund","family":"Povlsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claus","family":"Moser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morten Holdgaard","family":"Smerup","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Faurholt-Jepsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henning","family":"Bundgaard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauge","family":"\u00d8stergaard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars","family":"K\u00f8ber","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emil Loldrup","family":"Fosb\u00f8l","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,31]]},"reference":[{"key":"2960_CR1","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1016\/S0025-6196(25)00675-5","volume":"57","author":"RD Pruitt","year":"1982","unstructured":"Pruitt RD. William Osler and his Gulstonian lectures on malignant endocarditis. Mayo Clin Proc. 1982;57:4\u20139. https:\/\/doi.org\/10.1016\/S0025-6196(25)00675-5.","journal-title":"Mayo Clin Proc"},{"key":"2960_CR2","doi-asserted-by":"publisher","first-page":"3948","DOI":"10.1093\/eurheartj\/ehad193","volume":"44","author":"V Delgado","year":"2023","unstructured":"Delgado V, Ajmone Marsan N, de Waha S, Bonaros N, Brida M, Burri H, et al. 2023 ESC guidelines for the management of endocarditis. Eur Heart J. 2023;44:3948\u20134042. https:\/\/doi.org\/10.1093\/eurheartj\/ehad193.","journal-title":"Eur Heart J"},{"key":"2960_CR3","doi-asserted-by":"publisher","first-page":"1230","DOI":"10.1093\/cid\/cis199","volume":"54","author":"C Selton-Suty","year":"2012","unstructured":"Selton-Suty C, C\u00e9lard M, Le Moing V, Doco-Lecompte T, Chirouze C, Iung B, et al. Preeminence of Staphylococcus aureus in infective endocarditis: a 1-year population-based survey. Clin Infect Dis. 2012;54:1230\u20139. https:\/\/doi.org\/10.1093\/cid\/cis199.","journal-title":"Clin Infect Dis"},{"key":"2960_CR4","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1080\/07853890.2016.1235282","volume":"49","author":"Y N\u2019Guyen","year":"2017","unstructured":"N\u2019Guyen Y, Duval X, Revest M, Saada M, Erpelding M-L, Selton-Suty C, et al. Time interval between infective endocarditis first symptoms and diagnosis: relationship to infective endocarditis characteristics, microorganisms and prognosis. Ann Med. 2017;49:117\u201325. https:\/\/doi.org\/10.1080\/07853890.2016.1235282.","journal-title":"Ann Med"},{"key":"2960_CR5","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1016\/j.medcli.2020.01.027","volume":"155","author":"S Urso","year":"2020","unstructured":"Urso S, Tena M\u00c1, Gonz\u00e1lez-Barbeito M, Paredes F, Quevedo V, Portela F, et al. 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Am Heart J. 2025;285:119\u201332. https:\/\/doi.org\/10.1016\/j.ahj.2025.02.006.","journal-title":"Am Heart J"},{"key":"2960_CR9","doi-asserted-by":"publisher","first-page":"3075","DOI":"10.1093\/eurheartj\/ehv319","volume":"36","author":"G Habib","year":"2015","unstructured":"Habib G, Lancellotti P, Antunes MJ, Bongiorni MG, Casalta J-P, Del Zotti F, et al. 2015 ESC guidelines for the management of infective endocarditis. Eur Heart J. 2015;36:3075\u2013128. https:\/\/doi.org\/10.1093\/eurheartj\/ehv319.","journal-title":"Eur Heart J"},{"key":"2960_CR10","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.125.074608","author":"PL Graversen","year":"2025","unstructured":"Graversen PL, \u00d8stergaard L, Hadji-Turdeghal K, M\u00f8ller JE, Bruun NE, Povlsen JA, et al. Clinical practice of surgical treatment for left-sided infective endocarditis: nationwide data from the NIDUS registry. Circulation. 2025. https:\/\/doi.org\/10.1161\/CIRCULATIONAHA.125.074608.","journal-title":"Circulation"},{"key":"2960_CR11","doi-asserted-by":"publisher","first-page":"995508","DOI":"10.3389\/fcell.2022.995508","volume":"10","author":"JJP Kouijzer","year":"2022","unstructured":"Kouijzer JJP, Noordermeer DJ, van Leeuwen WJ, Verkaik NJ, Lattwein KR. Native valve, prosthetic valve, and cardiac device-related infective endocarditis: a review and update on current innovative diagnostic and therapeutic strategies. Front Cell Dev Biol. 2022;10:995508. https:\/\/doi.org\/10.3389\/fcell.2022.995508.","journal-title":"Front Cell Dev Biol"},{"key":"2960_CR12","doi-asserted-by":"publisher","unstructured":"Khaloo P, Uzomah UA, Shaqdan A, Ledesma PA, Galvin J, Ptaszek LM, et al. Outcomes of patients hospitalized with cardiovascular implantable electronic device\u2013related infective endocarditis, prosthetic valve endocarditis, and native valve endocarditis: a nationwide study, 2003 to 2017. 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