Infective Endocarditis: Experience of the Cardiology Department of the Mohammed VI University Hospital
Hind Nabawi *
Cardiology Department, Mohammed VI University Hospital, Marrakech, Morocco.
Mina Boutgourine
Cardiology Department, Mohammed VI University Hospital, Marrakech, Morocco.
Bouchra Maatof
Cardiology Department, Mohammed VI University Hospital, Marrakech, Morocco.
Mohammed El Jamili
Cardiology Department, Mohammed VI University Hospital, Marrakech, Morocco.
Saloua El Karimi
Cardiology Department, Mohammed VI University Hospital, Marrakech, Morocco.
Mustapha El Hattaoui
Cardiology Department, Mohammed VI University Hospital, Marrakech, Morocco.
*Author to whom correspondence should be addressed.
Abstract
Introduction: Infective endocarditis (IE) is a rare but potentially serious disease. It causes a high mortality and a high level of morbidity and complications. Its epidemiological, clinical and microbiological characteristics have changed in recent years.
The Aim of our Work: Is to study the epidemiological, clinical, bacteriological, ultrasonographic, therapeutic and evolutionary data of IE between January 2017 and October 2022 in the Mohammed VI University Hospital and to compare them to the global profile.
Materials and Methods: Retrospective study including 110 patients hospitalized for a definite IE, according to the modified DUKE criteria, in the cardiology department of the Mohammed VI University Hospital over a period of 5 years and 10 months from January 2017 to October 2022.
Results: The average age of our patients was 43 years with a male predominance. The bacterial graft was on native valve in 80% with predominance of rheumatic origin (69%), on cardiac prosthesis in 10% of patients, on healthy heart (4%) and congenital heart disease (6%). The most frequent portal of entry was dental (30%). Blood cultures were positive only in 33% of patients, isolating a staphylococcus (16%), a streptococcus (14%) and a GNB (3%). Transthoracic echocardiography (TTE) showed vegetation in 108 cases, valve perforation in 7 cases, cord rupture in 1 patient and perivalvular abscess in 10 cases. Seventy-seven percent of patients had surgical treatment with a mean delay of 29 days. The overall mortality was 24% with heart failure (p<0.001), renal failure (p=0.004) and neurological complications (p=0.002) as predictive factors of mortality.
Conclusion: Infective endocarditis remains a real health problem with a consequent mortality and morbidity. The population is often young, revealing the IE by complications; its prevention is the best way to improve its prognosis.
Keywords: Infective endocarditis, entry portal, echocardiography, blood culture, complications, surgery, prognosis