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Infective endocarditis-experience in Nigeria
Insights
This review of infective endocarditis cases found rheumatic heart disease common in subacute cases. High mortality and late diagnosis highlight the need for increased awareness and prompt treatment of this serious heart infection.
Area of Science:
- Cardiology
- Infectious Diseases
- Internal Medicine
Background:
- Infective endocarditis (IE) is a serious infection affecting heart valves.
- Understanding the epidemiology and clinical features of IE is crucial for timely diagnosis and management.
Purpose of the Study:
- To review cases of infective endocarditis at University College Hospital, Ibadan.
- To identify common pre-existing conditions, causative organisms, diagnostic challenges, and outcomes.
Main Methods:
- Retrospective review of 90 infective endocarditis cases over a 10-year period.
- Analysis of patient demographics, clinical presentation, pre-existing heart disease, microbiological data, and mortality.
Main Results:
- Peak incidence occurred in the third decade.
- Rheumatic heart disease was the most frequent pre-existing lesion in subacute endocarditis (59 cases).
- Diagnosis was made post-mortem in 44% of cases; bacterial isolation rate was low.
- Overall mortality was high at 70%.
Conclusions:
- Infective endocarditis presents diagnostic challenges, often being diagnosed late.
- Rheumatic heart disease is a significant predisposing factor.
- There is an urgent need to increase awareness and ensure prompt treatment to reduce the high mortality associated with infective endocarditis.
Abstract:
Ninety cases of infective endocarditis seen over a 10-year-period at University College Hospital, Ibadan, are reviewed. The peak incidence was in the third decade and rheumatic heart disease was the commonest pre-existing lesion in 59 cases with subacute endocarditis. In most cases the source of infection was not known. In 41 of the 90 cases (44%) the diagnosis was made only at autopsy. The bacterial isolation rate was low, the commonest organisms being staphylococci, streptococci, micrococci and gramnegative bacilli. The overall mortality was 70%. A plea is made for increasing awareness of the disease and prompt institution of effective treatment.