Prospective study of infective endocarditis from a developing country.

Area of Science:

• Cardiology
• Infectious Diseases
• Epidemiology

Background:

• Infective endocarditis (IE) profiles are changing globally, yet data from developing nations remain scarce.
• This study addresses the need for prospective research on IE in developing countries.

Purpose of the Study:

• To investigate predisposing factors, clinical manifestations, diagnostic approaches, microbiological findings, and patient outcomes in definite IE.
• To establish a comprehensive understanding of IE in a developing country context.

Main Methods:

• A prospective observational study design was employed.
• Consecutive cases of definite IE were identified using the modified Duke criteria.

Main Results:

• 104 definite IE cases were identified (2004-2006) with a mean age of 23.5 years; congenital heart disease was the leading predisposing factor (39.4%).
• Echocardiography demonstrated high diagnostic utility (96.7%), but blood cultures had low positivity rates (41%).
• High complication rates (73%), low surgical intervention rates (15%), and a significant in-hospital mortality (26%) were observed.

Conclusions:

• IE in India presents with a younger demographic and a higher prevalence of congenital heart disease compared to Western populations.
• Low culture positivity and surgical rates contribute to high morbidity and mortality associated with IE in India.
• Underlying heart disease and septic shock independently predict mortality in IE patients.