Active infective endocarditis observed in an Indian hospital 1981-1991.
Clinical data from 186 patients (133 males and 53 females) with 190 episodes of infective endocarditis (IE) occurring between January 1981 and July 1991 were studied retrospectively at a large referral hospital in Northern India with the intention of highlighting certain essential differences from those reported in the West. The mean age was much lower (25 +/- SD 12 years, range 2 to 75 years). Rheumatic heart disease was the most frequent underlying heart lesion accounting for 79 patients (42%). This was followed by congenital heart disease in 62 (33%) and normal valve endocarditis in 17 (9%). Twenty-four patients had either aortic regurgitation (n = 15) or mitral regurgitation (n = 9) of uncertain etiology. Prosthetic valve infection and mitral valve prolapse were present in only 2 patients each. A definite predisposing factor could be identified in only 28 patients (15%). Postabortal sepsis and sepsis related to childbirth accounted for 6 and 5 cases, respectively. Only 1 patient had history of intravenous drug abuse. Two-dimensional echocardiography showed vegetations in 121 patients (64%). Blood cultures were positive in only 87 (47%), with a total of 90 microbial isolates. Commonest infecting organisms were staphylococci (37 cases) and streptococci (34 cases). Except for a significantly higher number of patients with neurologic complications in the culture-negative group, there were no differences between patients with culture-positive and culture-negative IE. Of the 190 episodes of IE, the patients had received antibiotics before admission in 110 (58%) instances. A significantly greater number of culture-negative patients had received antibiotics than did culture-positive patients (87 vs 23, p < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)
Choudhury
R
R
Department of Cardiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Grover
A
A
Varma
J
J
Khattri
H N
HN
Anand
I S
IS
Bidwai
P S
PS
Wahi
P L
PL
Sapru
R P
RP
D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016470:Bacteremia / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D004452:Echocardiography; D004617:Embolism / Q000209:etiology; D004697:Endocarditis, Bacterial / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology / Q000503:physiopathology; D005260:Female; D006330:Heart Defects, Congenital / Q000453:epidemiology; D006333:Heart Failure / Q000209:etiology; D006349:Heart Valve Diseases / Q000453:epidemiology; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012214:Rheumatic Heart Disease / Q000453:epidemiology; D012307:Risk Factors; D013203:Staphylococcal Infections; D013290:Streptococcal Infections; D015996:Survival Rate
D000900:Anti-Bacterial Agents