<strong>Background</strong>: infective endocarditis is considered a serious condition due to the aggressiveness of the infectious agent that causes it, the valve damage and multiple organ involvement that can occur. <br /><strong>Objective</strong>: to describe the clinical and epidemiological characteristics of infective endocarditis diagnosed at autopsy. <br /><strong>Methods</strong>: a retrospective descriptive study of cases of infective endocarditis diagnosed at autopsy between 1986 and 2008 was conducted in the Celia Sánchez Manduley Provincial Clinical-Surgical Hospital in Granma, Cuba. <br /><strong>Results</strong>: frequency of infective endocarditis diagnosed at autopsy ranged annually from 0.4 to 1.5% in 13 376 autopsies performed on deceased patients over 15 years. The most common pathogen was Staphylococcus aureus. Mean age was 44 ± 26.2 years. Fever, tachycardia, paleness and heart murmurs were found in over 90% of the cases. Symptoms of nerve damage were observed in more than a quarter of the cases. The most frequent sources of infection were instrumentations, particularly intravenous therapy. Nosocomial endocarditis was also found. <br /><strong>Conclusion</strong>: the results showed changes in the epidemiology of infective endocarditis in recent years. In most cases, its course was acute, with widespread severe sepsis, multiple organ failure and severe cardiac dysfunction
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