title: [Neurological complications of infective endocarditis in Burkina Faso. Clinical features, management and evolutionary profile].
abstract: BACKGROUND
  Neurological complications are the most frequent extracardiac complications of infective endocarditis (IE). This study aimed to describe the epidemiological, clinical and paraclinical aspects, and outcome of neurological complications of infective endocarditis in three hospitals in the city of Ouagadougou in Burkina Faso.
  
  
  METHODS
  From 1 January 2009 to 31 December 2012, we included all patients suffering from IE and selected those in whom a neurological complication was objectified. Neurological involvement was sought on clinical examination but especially CT brain (ischemic infarcts, hemorrhages, aneurysms and abscesses). Blood cultures were systematic. Echocardiography was done for vegetations and characteristics.
  
  
  RESULTS
  Among 63 cases of IE, neurological complications were found in 14 patients (22.2%). The average age of patients with neurological complications was 37.4 ± 5.8 years. The sex ratio was 1.3 for women. Neurological damage consisted of nine cases of stroke (64.3%), three cases of hemorrhagic stroke (21.4%) and two cases of brain abscess (14.3%). Neurological complications had already occurred before hospitalization in 4 cases. Blood cultures were positive in 8 cases. Germs found were predominantly Staphylococcus aureus (5 cases) and Streptococcus a- viridans (2 cases). All cases of S. aureus were complicated by stroke. At echocardiography, vegetation was found in all cases. It was found on the mitral in 7 cases, the aorta in 3 cases, the mitral and aortic in 2 cases and the mitral and tricuspid in 2 cases also. The EI had occurred on a native valve in 11 cases, prosthesis in 4 cases (2 mitral and 2 aortic). The vegetations average diameter was 11.2 ± 2.1 mm (6.4 and 1 7.7 mm). Vegetations were mobile in 12 cases. The treatment consisted of antibiotics adapted to the antibiogram, neurological and cardiovascular monitoring. The evolution was marked by seven deaths (50%), including 5 deaths related to cerebral complication (71.4% of deaths).
  
  
  CONCLUSIONS
  This study shows that neurological complications during infective endocarditis are frequent, dominated by stroke with a high mortality.
authors.affiliation: Service de cardiologie, CHU Yalgado Ouédraogo, 03 PB : 7022, Ouagadougou 03, Burkina Faso. Electronic address: drnova@hotmail.fr.
authors.forename: N V
authors.initials: NV
authors.lastname: Yaméogo
authors.affiliation: Service de cardiologie, CHU Yalgado Ouédraogo, 03 PB : 7022, Ouagadougou 03, Burkina Faso.
authors.forename: A
authors.initials: A
authors.lastname: Seghda
authors.affiliation: Service de cardiologie, CHU Yalgado Ouédraogo, 03 PB : 7022, Ouagadougou 03, Burkina Faso.
authors.forename: L J
authors.initials: LJ
authors.lastname: Kagambèga
authors.affiliation: Service de cardiologie, CHU Yalgado Ouédraogo, 03 PB : 7022, Ouagadougou 03, Burkina Faso.
authors.forename: O
authors.initials: O
authors.lastname: Diallo
authors.affiliation: Service de cardiologie, CHU Yalgado Ouédraogo, 03 PB : 7022, Ouagadougou 03, Burkina Faso.
authors.forename: G R C
authors.initials: GR
authors.lastname: Millogo
authors.affiliation: Service de cardiologie, CHU Yalgado Ouédraogo, 03 PB : 7022, Ouagadougou 03, Burkina Faso.
authors.forename: B J Y
authors.initials: BJ
authors.lastname: Toguyéni
authors.affiliation: Service de cardiologie, CHU Yalgado Ouédraogo, 03 PB : 7022, Ouagadougou 03, Burkina Faso.
authors.forename: A K
authors.initials: AK
authors.lastname: Samadoulougou
authors.affiliation: Service de cardiologie, CHU Yalgado Ouédraogo, 03 PB : 7022, Ouagadougou 03, Burkina Faso.
authors.forename: A
authors.initials: A
authors.lastname: Niakara
authors.affiliation: Service de cardiologie, CHU Yalgado Ouédraogo, 03 PB : 7022, Ouagadougou 03, Burkina Faso.
authors.forename: J
authors.initials: J
authors.lastname: Simporé
authors.affiliation: Service de cardiologie, CHU Yalgado Ouédraogo, 03 PB : 7022, Ouagadougou 03, Burkina Faso.
authors.forename: P
authors.initials: P
authors.lastname: Zabsonré
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001922:Brain Abscess / Q000175:diagnosis / Q000382:microbiology*; D002050:Burkina Faso / Q000453:epidemiology; D003430:Cross-Sectional Studies; D004696:Endocarditis / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy / Q000401:mortality; D004697:Endocarditis, Bacterial / Q000150:complications / Q000175:diagnosis; D005260:Female; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D011379:Prognosis; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy / Q000401:mortality; D013211:Staphylococcus aureus / Q000302:isolation & purification; D013290:Streptococcal Infections / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy / Q000401:mortality; D013291:Streptococcus / Q000302:isolation & purification; D020521:Stroke / Q000175:diagnosis / Q000382:microbiology*; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents
keywords: Burkina Faso; Complications neurologiques; Endocardite infectieuse; Infective endocarditis; Neurological complications