CULTURE NEGATIVE INFECTIVE ENDOCARDITIS – A CASE SERIES IN A TEACHING HOSPITAL IN RURAL INDIA

Abstract

Background- Infective endocarditis (IE) is an infection of endocardial surface of the heart. It commonly involves heart valves but may also involve other endocardial sites in heart. The incidence is 3 to 10 per one lakh with mortality of 30%. Viridian streptococci and staph aureus are common causative organism, 6% of cases are culture negative IE. Aims and Objectives-To report 5 cases of culture negative infective endocarditis and to study predisposing factors, response to treatment and outcome. Materials And Methods-The study was conducted in patients admitted in Department of Pediatrics, Dr. Vitthalrao Vikhe Patil Pravara Rural Hospital ,Loni from January 2022 to June 2022 and diagnosed as IE by modied Duke's criteria, detailed history was taken to assess the risk factors and clinical examination, 2d echocardiography, serial blood culture, careful monitoring is done to look for response treatment and outcome. Results- During the study period total 8 cases were diagnosed as infective endocarditis out of which 5 cases were found to be culture negative IE.Out of 5 cases, 4 patient had congenital heart disease and 1 patient had RHD as predisposing factor,4 survived and 1 patient expired.3 patient responded to empirical antibiotic treatment, while 1 patient was reffered to higher center for surgery due to failure of medical management. Conclusion-Infective endocarditis prophylaxis in patient with risk factors is appropriate step in prevention and proper blood culture technique , prompt clinical examination and imaging remains the mainstay in diagnosis of IE.Antibiotic policy according to the protocol and 2d echocardiographical surveillance reects the outcome.