Abstract
IntroductionData on infective endocarditis (IE) in Southeast Asia are scarce. ObjectivesTo describe the clinical epidemiology of IE in Lao PDR, a lower middle-income country. MethodsA single centre retrospective study at Mahosot Hospital, Vientiane. Patients aged over 1year of age admitted 2006–2012 to Mahosot Hospital with definite or possible IE by modified Duke criteria were included. ResultsThirty-six patients fulfilled the inclusion criteria; 33 (91.7%) had left-sided IE. Eleven (30.6%) had definite IE and 25 (69.4%) possible left-sided IE. Median age was 25years old [IQR 18–42]. Fifteen patients (41.7%) were males. Underlying heart diseases included: rheumatic valve disease in 12 (33.3%), congenital heart disease in 7 (19.4%), degenerative valve disease in 3 (8.3%), and of unknown origin in 14 (38.9%) patients. Native valve IE was present in 30 patients (83.3%), and prosthetic valve IE in 6 patients (16.7%). The most frequent pathogens were Streptococcus spp. in 7 (19.4%). Blood cultures were negative in 22 patients (61.1%). Complications included: heart failure in 11 (30.6%), severe valve regurgitation in 7 (19.4%); neurological event in 7 (19.4%); septic shock or severe sepsis in 5 (13.9%); and cardiogenic shock in 3 patients (8.3%). No patient underwent heart surgery. Fourteen (38.9%) had died by follow-up after a median of 2.1years [IQR 1–3.2]; and 3 (8.3%) were lost to follow-up. ConclusionsInfective endocarditis, a disease especially of young adults and mainly caused by Streptococcus spp., was associated with rheumatic heart disease and had high mortality in Laos.
Highlights
Data on infective endocarditis (IE) in Southeast Asia are scarce
We describe the clinical characteristics of IE in patients admitted to a tertiary teaching hospital, in Vientiane, the Lao PDR (Laos), a lower middle-income country, and examined their long-term outcomes
Patients aged over 1 year admitted from January 2006 to January 2012 to Mahosot Hospital with definite or possible IE according to the modified Duke criteria were included in the study [12]
Summary
Data on infective endocarditis (IE) in Southeast Asia are scarce. Objectives: To describe the clinical epidemiology of IE in Lao PDR, a lower middle-income country. Patients aged over 1 year of age admitted 2006–2012 to Mahosot Hospital with definite or possible IE by modified Duke criteria were included. Complications included: heart failure in 11 (30.6%), severe valve regurgitation in 7 (19.4%); neurological event in 7 (19.4%); septic shock or severe sepsis in 5 (13.9%); and cardiogenic shock in 3 patients (8.3%). Conclusions: Infective endocarditis, a disease especially of young adults and mainly caused by Streptococcus spp., was associated with rheumatic heart disease and had high mortality in Laos. Infective endocarditis (IE) is a rare but severe disease that still has a high mortality, even in those with access to tertiary centres. Driven by other epidemiological characteristics, the challenges and treatment options the physician encounters in middle and low-income settings may differ greatly from those described in the medical literature
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