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[Infectious endocarditis: Experience of a cardiology department at Oran university hospital]

N F Benatta¹, D D Batouche¹, S Benouaz²

¹Faculté de médecine, Oran, Algérie.

Annales De Cardiologie Et D'Angeiologie

|October 11, 2018

Insights

Infectious endocarditis (IE) is a serious condition often affecting young adults, frequently presenting with complications. Diagnosis relies heavily on echocardiography and blood cultures, with surgery being crucial for better outcomes.

Area of Science:

Cardiology
Infectious Diseases
Internal Medicine

Background:

Infectious endocarditis (IE) remains a significant clinical challenge with evolving diagnostic and therapeutic landscapes.
The disease necessitates a comprehensive understanding of its presentation and management.

Purpose of the Study:

To analyze the diagnostic profile of infectious endocarditis.
To evaluate the treatment and outcome of IE patients.

Main Methods:

A retrospective analysis of 57 definite IE cases diagnosed using modified Duke criteria.
Data collected included clinical, paraclinical, therapeutic, and outcome variables from January 2011 to June 2017.

Main Results:

The study population had a mean age of 40.5 years, with male predominance.
Native valve IE was most common (70%), with oral origin as a frequent source of infection.
Staphylococcus (22.6%) and Streptococcus (18.9%) were leading pathogens; echocardiography revealed vegetation in 83% and complications like neurological issues (27%) and hemodynamic instability (26%) were prevalent.
Hospital mortality was 26%, with Staphylococcus infection, cardiac insufficiency, and neurological complications as significant predictors.

Conclusions:

Infectious endocarditis is a severe disease, particularly without surgical intervention.
Echocardiography and blood cultures are primary diagnostic tools.
The affected population is often young, with complications frequently being the initial presentation, highlighting the importance of prevention for improved prognosis.

Read full analysis

Abstract

Introduction:

Infectious endocarditis (IE) is a serious disease that has continued to evolve in diagnostic and therapeutic terms.

Aim:

To analyze the diagnostic and out come profile.

Methods:

We collected 57 (IE) cases with a definite diagnosis according to the modified Duke criteria. Patients were admitted consecutively to the Cardiology Department of the Oran university hospital from January 2011 to June 2017. Among the variables studied: clinical data, paraclinic data, therapeutic management and hospital outcome.

Results:

The mean age was 40.5±15 years (extreme 16-67 years), with a male predominance (sex-ratio=1.5). This was a native valve IE in 70% of cases, on valve prosthesis in 15.5% of patients, on congenital heart disease in 2% and on pacemaker probe in 4% of cases. The entrance door was dominated by oral origin. Blood cultures were positive only in 51% of cases. The most commonly implicated organism in staphylococci in 22.6%, streptococcus in 18.9% and brucellosis in 3.8%. Ultrasound data revealed vegetation (83%), cardiac abscess (19%), valvular perforation (15.1%) and prosthesis disintegration (7.5%). Complications were mainly neurological complications (27%) and hemodynamics (26%). Cardiac surgery occurred in 29% of patients. Hospital mortality was 26%, predictive factors were staphylococcal AI (P<0.001), cardiac insufficiency (P<0.001) and neurological complications (P=0.04).

Conclusion:

Infectious endocarditis is a serious disease in the absence of surgery. The diagnosis is based on echocardiography in the first place and blood cultures. The population is often young revealing the EI by complications; its prevention is the best way to improve its prognosis.

Keywords:

Chirurgie Echocardiography Endocardite infectieuse Endocarditis infectious Microbiologie complications Microbiology complications Pronostic Surgery, Prognosis Échocardiographie

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