N F Benatta1, D D Batouche2, S Benouaz3, M A Djazouli2. 1. Faculté de médecine, Oran, Algérie. Electronic address: benattanadia@yahoo.fr. 2. Faculté de médecine, Oran, Algérie. 3. Faculté de médecine de Sidi bel Abbes, Oran, Algérie.
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.
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.