Infective Endocarditis: A Challenging Disease

Infective endocarditis: a five-year experience at a tertiary care hospital in Pakistan

“…In our study men were twice as likely to develop endocarditis as women, and male:female ratios as high as 3.4:1 have been previously reported. 6 Series of endocarditis from the pre-antibiotic era did not describe any difference in gender prevalence. 19,33,34 The male predominance seen in our study cohort is likely explained by sociocultural determinants of access to health care within our society.…”

“…Acute rheumatic fever has declined sharply (although rheumatic heart disease is still a major risk factor for infective endocarditis in most developing countries) and degenerative valvular lesions have become the most frequent anatomic abnormalities predisposing to infection. [1][2][3][4][5][6][7] In industrialized nations, early correction of congenital cardiac defects with subsequent risk reduction for infection has also played a role in the shift of underlying heart disease leading to endocarditis. [8][9][10] New developments in the diagnosis and management of infective endocarditis have influenced the pattern of disease seen in developed countries, particularly as related to early surgical intervention and reduced mortality.…”

“…[8][9][10] New developments in the diagnosis and management of infective endocarditis have influenced the pattern of disease seen in developed countries, particularly as related to early surgical intervention and reduced mortality. 2,[4][5][6][7]11,27,36,37 Data regarding the pattern and outcome of infective endocarditis from developing countries are sparse [12][13][14][15] and there have been no large series of endocarditis among adult patients reported from Pakistan. We sought to determine the predisposing factors, demographic and clinical characteristics, and outcomes of patients with infective endocarditis in our region of the world, and compare the results with recent studies from the West.…”

Pyrexia of unknown origin: changing spectrum of diseases in two consecutive series

“…The use of ultrasonography during the first week of work-up explains the lack of abdominal abscess and certain hepatobiliary diseases; echocardiography and improved bacteriological techniques perhaps explain why no cases of endocarditis presented as PUO. 20 Similarly, other bacterial infections such as brucellosis are less frequently associated with PUO than in the past.' Nowadays other infections, mainly of viral origin including cytomegalovirus or chronic Epstein-Barr virus infections, are more prevalent.7'8'2' In agreement with other authors, diagnosis of factitious fever, chronic active hepatitis, Crohn's disease and idiopathic granulomatosis were prominent amongst the miscellaneous causes of PUO.…”

Türki̇ye Yüksek İhti̇sas Hastanesi̇ Kardi̇yoloji̇ Kli̇ni̇ği̇nde Ocak 1990-Aralik 1995 Arasinda İzlenen İnfekti̇f Endokardi̇t Vakalarinin Kli̇ni̇k, Bakteri̇yoloji̇k Ve Ekokardi̇yografi̇k Değerlendi̇ri̇lmesi̇

“…Yeni çalışmalarda mitral valv prolapsusu infektif endokardit vakalarının önemli bir kısmından sorumlu tutulmuş, bir seride %32 bir başka seride %54 oranın-da prolapsusun zeminde yatan kardiyak patoloji olduğu bildirilmiştir (3,17). Biz ise vakalarımızın ancak %8'inde mitral veya aort kapak prolapsusu ile beraber İE teşhis ettik.…”