PROFILE OF INFECTIVE ENDOCARDITIS IN A TERTIARY CARE HOSPITAL

Abstract

Objective: The objective was to find the clinical, microbiologic and
echocardiographic profile of infective endocarditis (IE) in our local population.
Methodology: It was a retrospective study conducted at department of
Cardiology, Lady Reading Hospital, Peshawar. Medical records of all patients
admitted between September 2009 and August 2012 were reviewed. Both adults
and children, having a diagnosis of “definite IE”, based on the modified Duke's
criteria, were included. Patients who were labelled possible or rejected IE, were
excluded.
Results: A total of 34 patients were studied. Their mean age was 26±11 years.
Male were 24(70.59%). Most common presenting complaint was fever,
25(73.53%), followed by dyspnoea 16(47%) and palpitations in 05(14.71%)
patients. Echocardiography showed rheumatic heart disease to be the
commonest underlying lesion, present in 24(70.59%) patients and among these,
the most common valvular lesion was mitral regurgitation 12(35%). Other
underlying lesions included CHD in 5(14.71%), prosthetic valve in 3(8.82%)and
mitral valve prolapse with mitral regurgitation in 2(5.88%). Native mitral valve
was the commonest site for vegetation in 13(38%) patients, followed by native
aortic valve in 10(29%), tricuspid valve in 2(5.88%) and prosthetic valve in
2(5.88%) patients. Majority of the patients 17(50%) had negative blood culture
results. In 13(38%) of the patients, blood cultures were positive, amongst which
the commonest pathogens were streptococcus 6(17.65%) followed by
staphylococcus 5(14.71%).
Conclusion: In our local population, infective endocarditis usually occurs in
young adults with rheumatic heart disease. Blood culture results are negative in
majority of cases.