title: A Study of Clinical, Microbiological, and Echocardiographic Profile of Patients of Infective Endocarditis.
abstract: Infective endocarditis, a great masquerader, is a clinical entity which may present with a myriad of manifestations. Its changing epidemiological profile has been studied in the previous decades in both the developed and the developing nations. In this study, we strived to uphold the evolving clinical profile and its outcome from a government tertiary care hospital in Northern India. It was a descriptive, cross-sectional, observational study conducted over two years' period involving 44 patients diagnosed with definite infective endocarditis, according to modified Dukes' criteria. Demographic, clinical, microbiological, and echocardiographic data were analysed. Mean age of patients was 31 years. Rheumatic heart disease with regurgitant lesions was the commonest risk factor. Dyspnea and fever were the predominant symptom, and pallor and heart failure the commonest sign. Cultures were positive in 52% with Staphylococcus, the major isolate. Transesophageal echocardiography fared better than transthoracic one to define the vegetations. Mortality is reported in 4.5%. Prolonged duration of fever, pallor, hematuria, proteinuria, rheumatoid factor positivity, and large vegetations proved to be poor prognostic variables. Culture positive endocarditis, with persistent bacteremia, had higher incidence of acute renal failure. Right sided endocarditis was frequent in congenital lesions or IV drug user, whereas left sided endocarditis mostly presented with atrial fibrillation.
authors.affiliation: Department of Medicine, PGIMER, Dr. RML Hospital, New Delhi 110001, India.
authors.forename: Soumik
authors.initials: S
authors.lastname: Ghosh
authors.affiliation: Department of Medicine, PGIMER, Dr. RML Hospital, New Delhi 110001, India.
authors.forename: Ratnakar
authors.initials: R
authors.lastname: Sahoo
authors.affiliation: Department of Cardiology, PGIMER, Dr. RML Hospital, New Delhi 110001, India.
authors.forename: Ranjit Kumar
authors.initials: RK
authors.lastname: Nath
authors.affiliation: Department of Microbiology, PGIMER, Dr. RML Hospital, New Delhi 110001, India.
authors.forename: Nandini
authors.initials: N
authors.lastname: Duggal
authors.affiliation: Department of Medicine, PGIMER, Dr. RML Hospital, New Delhi 110001, India.
authors.forename: Adesh Kumar
authors.initials: AK
authors.lastname: Gadpayle