PROFILE OF INFECTIVE ENDOCARDITIS IN A TERTIARY CARE HOSPITAL

Objective: The objective was to find the clinical, microbiologic and echocardiographic profile of infective endocarditis (IE) in our local population. Methodology: It was a retrospective study conducted at department of Cardiology, Lady Reading Hospital, Peshawar. Medical records of all patients admitted between September 2009 and August 2012 were reviewed. Both adults and children, having a diagnosis of "definite IE", based on the modified Duke's criteria, were included. Patients who were labelled possible or rejected IE, were excluded. Results: A total of 34 patients were studied. Their mean age was 26 +/- 11 years. Male were 24(70.59%). Most common presenting complaint was fever, 25(73.53%), followed by dyspnoea 16(47%) and palpitations in 05(14.71%) patients. Echocardiography showed rheumatic heart disease to be the commonest underlying lesion, present in 24(70.59%) patients and among these, the most common valvular lesion was mitral regurgitation 12(35%). Other underlying lesions included CHD in 5(14.71%), prosthetic valve in 3(8.82%) and mitral valve prolapse with mitral regurgitation in 2(5.88%). Native mitral valve was the commonest site for vegetation in 13(38%) patients, followed by native aortic valve in 10(29%), tricuspid valve in 2(5.88%) and prosthetic valve in 2(5.88%) patients. Majority of the patients 17(50%) had negative blood culture results. In 13(38%) of the patients, blood cultures were positive, amongst which the commonest pathogens were streptococcus 6(17.65%) followed by staphylococcus 5(14.71%). Conclusion: In our local population, infective endocarditis usually occurs in young adults with rheumatic heart disease. Blood culture results are negative in majority of cases.