Study of infective endocarditis in Alexandria main university hospitals

Abstract

Objectives: To describe the incidence, clinical characteristics, microbiological profile and in-hospital outcome of infective endocarditis (IE) in our center. Methods: A prospective study that was conducted on 50 consecutive patients admitted to our cardiology department diagnosed as Duke definite IE. The study was conducted for a period of one year and started on the 1st of September 2009 till the end of August 2010. All patients were subjected to detailed history taking, clinical examination, blood culture and echocardiography. Results: The study was carried out on 29 males (58%) and 21 females (42%) with a mean age of 33 years. The mean duration of delay from onset of symptoms till diagnosis was 54 days. Native valve endocarditis was found in 34 patients (68%). Blood cultures were positive in 27 patients (54%). Staphylococci were the prevalent microorganisms (52%). In-hospital events included: heart failure in 29 patients (58%), systemic embolization in 13 patients (26%), para-valvular abscess in 8 patients (16%), septic pulmonary emboli in 7 patients (14%), dehiscence of prosthetic valves in 5 patients (10%) and renal failure in 2 patients (4%). Surgical intervention was indicated in 41 patients (82%). Only 16 patients (39%) had early surgical intervention. In-hospital mortality was 22%. However, the mortality rate improved in the patients who had undergone early surgical intervention (18.75% versus 32%). Conclusions: Infective endocarditis remains a major health problem. It carries high in-hospital events with a high mortality rate. Delayed diagnosis of the disease and culture negative IE are common. Staphylococci are the prevalent microorganisms. Early surgical intervention improves survival.

Keywords

• Infective endocarditis
• Blood culture
• Vegetation
• Intravenous drug abuser
• Native valve
• Prosthetic valve