Infective endocarditis in Principal Hospital of Dakar: a retrospective study of 42 cases over 10 years.

Autor:	Ba DM; Department of Cardiology, Principal Hospital of Dakar, Dakar, Senegal., Mboup MC; Department of Cardiology, Principal Hospital of Dakar, Dakar, Senegal., Zeba N; Department of Internal Medicine, Principal Hospital of Dakar, Dakar, Senegal., Dia K; Department of Cardiology, Principal Hospital of Dakar, Dakar, Senegal., Fall AN; Department of Internal Medicine, Principal Hospital of Dakar, Dakar, Senegal., Fall F; Department of Internal Medicine, Principal Hospital of Dakar, Dakar, Senegal., Fall PD; Department of Cardiology, Principal Hospital of Dakar, Dakar, Senegal., Gning SB; Department of Internal Medicine, Principal Hospital of Dakar, Dakar, Senegal.
Jazyk:	angličtina
Zdroj:	The Pan African medical journal [Pan Afr Med J] 2017 Jan 30; Vol. 26, pp. 40. Date of Electronic Publication: 2017 Jan 30 (Print Publication: 2017).
DOI:	10.11604/pamj.2017.26.40.10020
Abstrakt:	Infective Endocarditis (IE) is an endocardial infection usually caused by bacteria that affects not only the native heart valves but also, with increasing frequency intravascular implanted devices and congenital heart diseases. Despite medical advances, IE remains a life-threatening disease with substantial morbidity and mortality. In Africa, its diagnosis and treatment are still a major challenge in clinical practice. The objective of this work was to study the epidemiological, clinical features, diagnostic techniques currently used in medical practice and the range of micro-organisms that are responsible. This was a retrospective study done at Principal Hospital of Dakar. We include all patients who were admitted with clinical manifestations of definite or possible IE according to the extended DUKE criteria between January 1 st , 2005 and December 31 st , 2014. We collected and analyzed epidemiological, clinical, paraclinical and outcomes data of 42 patients. Hospital prevalence of IE was 0.078% (42/53711). The mean age was 27.5+/- 18 years with a sex ratio (M/F) of 0.55. IE were more common in patients with damaged or abnormal heart valves (78.6%) and in thoses with underlying structural defects (14.3%). The most common presenting symptoms were fever (90%) and cardiac murmurs (81%). Extracardiac clinical manifestations were very rare. The usual laboratory parameters of inflammation were elevated in 90% of patients. Blood cultures were negative in 50% of cases and positive in 21.4%. The main organism found was Staphylococcus aureus. Echocardiography found vegetations in 95.2% of cases, chamber enlargement in 73.8% and mitral regurgiation in 83.3%. Broad-spectrum penicillins including ampicillin and gentamycine were used for all patients. Major complications were heart failure (47.6%). Strokes and cerebral abcess (23.8%) and Vascular emboli 14.3%. Hospital mortality was 31%. IE remains a life-threatening disease with hight mortality despites improved techniques of diagnosis and modern antibiotics. Competing Interests: The authors declare no competing interests.
Databáze:	MEDLINE
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