284 Epidemiologic profil of infectious endocarditis in a moroccan unit of cardiology

Abstract

In the Moroccan context, infectious endocarditis (IE) is grafted in the majority of the cases on a preexistent heart disease. The goal of our work is to study the characteristics clinical, biological, echographic, therapeutic and the evolution of this affection in connection with a series of 31 cases. We made a retrospective study on a series of 31 patients admitted for IE retained according to the criteria of Duke in the service of cardiology to the university hospital Med VI of Marrakech, of the January 2007 to June 2009. 22cas (71%) of confirmed IE, 9 cases (29%) of strongly suspectée IE. The Middle Age was of 29+/−19 years, 18 men et13 women. A preexistent heart disease was known in 58% of the cases, of which: 12 rheumatic valvulopathies, 5 heart diseases congenital and 2 IE on valvular prosthesis. The time of consultation varied one to 60 days. The mode of revelation was: an infectious syndrome at 90% of the patients, a cardiac failure at 9 cases, a feverish neurological deficit at 3 cases and a peripheral ischaemia at one case. The main door was proven in 19 case (61%), of which: dental at 10 cases (32%), cutaneous at 4 cases (12%), digestive at 2 cases, pulmonary at 2 cases and urinary at only one has patience. The identification by echocardiography of a vegetation was of 87%. The hémocultures were positive at 15 cases (52%). The found germs were the staphilococcus aureus in 60%, the streptococcus in 20% and the bacilli gram negative in 10% of the cases. All the patients were treated by adapted antibiotherapy. The recourse to the surgery was noted in 28% of the cases. The complications were dominated by a cardiac failure in 9 cases, an arrhythmia supra ventricular in 3 cases, a péricarditis in 2 cases, an impaired renal insufficiency in 3 cases, a peripheral embolism in 2 cases, a repetition in 1 case and one case of death. This study confirmed clinical, bacteriological and echographic polymorphism, as well as the difficulty and the cost of the assumption of responsibility underlining the interest of the prevention.