Epidemiological and clinical features, ultrasound findings and prognosis of right-sided infective endocarditis in a teaching hospital in Ouagadougou.
BACKGROUND
Right-sided infective endocarditis is rare. It accounts about 5 to 10% of all infective endocarditis cases and is prevalent in patients with congenital heart disease, intravascular devices and drug addiction. Our study aimed to describe the epidemiological, clinical and echocardiographic characteristics of right-sided endocarditis and evaluate the prognosis after treatment.


METHODS
From January 2010 to December 2011 we recruited all patients admitted to Yalgado Ouedraogo Teaching Hospital for infective endocarditis, and selected those who had a right-sided location. The Duke criteria were used for diagnosis. We analysed entry points and underlying heart disease. The causative organisms were tracked using blood sample cultures. Ultrasound characteristics were described, and treatment and prognosis were evaluated. Patients' follow up was conducted from recruitment to 30 June 2012.


RESULTS
In the two-year period, 14 cases of right-sided infective endocarditis were recorded, including seven cases in children. They accounted for 29.1% of all infective endocarditis cases. The mean age was 25.5 ± 12.5 years (range 9-80 years). The venous route was implicated in 12 cases (85.7%). Blood cultures were positive in 11 patients. The bacteria isolated were Streptococcus pneumonia in six cases, Staphylococcus aureus in three and Hemophilus influenza in two cases. HIV status was positive in three patients. Underlying heart diseases were dominated by congenital heart disease in six cases and peripartal cardiomyopathy in four others. Vegetations were located in the right heart in only 11 cases. With antibiotic treatment, a lowering of temperature was shown within an average of 10 days of follow up. Two fatalities were reported.


CONCLUSIONS
This study showed that right-sided endocarditis is common in our clinical practice. This infection was prevalent in patients with congenital heart disease or peripartal cardiomyopathy in our context, and the venous route seemed to be the main entry point.
Yalgado Ouedraogo Teaching Hospital, Ouagadougou, Burkina Faso.
Nobila Valentin
NV
Yameogo
Kongnimisson Apoline
KA
Sondo
Aime Arsene
AA
Yameogo
Larissa Justine
LJ
Kagambega
D Germain
DG
Mandi
K Jonas
KJ
Kologo
Georges  R C
G
Millogo
B Jean Yves
BJ
Toguyeni
Andre K
AK
Samadoulougou
N Jean-Paul
NJ
Kabore
Patrice
P
Zabsonre
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002050:Burkina Faso; D002311:Cardiomyopathy, Dilated / Q000453:epidemiology*; D002648:Child; D004452:Echocardiography; D004697:Endocarditis, Bacterial / Q000175:diagnosis* / Q000453:epidemiology* / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006330:Heart Defects, Congenital / Q000453:epidemiology*; D006333:Heart Failure; D006351:Heart Valves / Q000000981:diagnostic imaging / Q000382:microbiology / Q000473:pathology; D006784:Hospitals, Teaching; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D013290:Streptococcal Infections / Q000175:diagnosis* / Q000453:epidemiology* / Q000401:mortality; D013296:Streptococcus pneumoniae / Q000302:isolation & purification* / Q000472:pathogenicity; D016019:Survival Analysis; D055815:Young Adult