Changing Pattern of Infective Endocarditis

Abstract

Introduction: Bacterial endocarditis or better called Infective endocaxditis which was first described by Osler (1) and Horder (2) remains one of the most serious complications of heart disease. It was a fatal disease till the introduction of Penicillin when the mortality fell from almost 100% to around 30% where it has generally stayed(3), though lower figures have been quoted from some major centres (4) in recent years. Patients and Methods: It was a prospective study convering all patients suspected of infective endocarditis admitted to cardiology unit, P.G.M.1./’%Rj-j from January 1985 to November, 1987. It was a prospective study covering all patients suspected of infective endocarditis admitted to cardiology unit, P.G.M.I./L.R.H. from January 1985 to November, 1987. Results: A total of 65 proformas were collected. Out of which only 45 were accepted with most probable Infective Endocarditis. 20 cases were discarded, as they proved to be non-endocarditic. Discussion: The mean age of 19 years for our patients was extremely low which was even lower than 31 year of pre-antibiotic era (6).In last 2-3 decades the mean age has steadily increased to 57 years (6,7) because of increase longevity and falling incidence of rheumatic heart disease.Blood cultures were positive in only 10 cases (22%). Out of which two cases of citobacter and Micrococcus were most probably contaminants while the rest 8 cases grew the same bacteria in at least two sets. This was in sharp contrast to other studies where the causative organisms were isolate d from 90% to 98% of cases (9, 12).We wish to thank Dr. Tasleem Akhtar, Director, PMRC, Peshawar and her lab oratory staff who kindly helped us in providing the blood culture facilities.