Endocarditis in Ethiopia. Analysis of 51 cases from Addis Ababa

Fifty-one cases of infective endocarditis in 47 Ethiopians over several years are analyzed. There were 32 males and 19 females, average age was 20.5, with 34 < or = 20. Only 2 patients had a known source of infection. Forty-four cases had underlying rheumatic heart disease, 7 had congenital heart disease of which 5 had patent ductus arteriosus. Staphylococcus aureus and S. epidermidis were the most commonly cultured organisms (10 each), only 1 streptococcus was isolated; 28/47 cultured cases had negative cultures. Eight patients (16%) died. In comparison with western studies, this group was much younger and had a higher prevalence of rheumatic heart disease. Mitral valve prolapse and degenerative valvular disease common in the West were not seen in this population. The rate of negative cultures was much higher than the 5-10% reported in the west, most likely due to previous use of antibiotics and problems with culture techniques.