Characteristics of infective endocarditis in a developing country-clinical profile and outcome in 192 Indian patients, 1992–2001

Garg, Naveen; Kandpal, Bhuwanesh; Garg, Nitish; Tewari, Saipriya; Kapoor, Aditya; Goel, Praveen; Sinha, Nakul

doi:10.1016/j.ijcard.2003.10.043

Cited by 100 publications

(110 citation statements)

References 33 publications

(56 reference statements)

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“…[19][20][21][22][23]25,31,32,34 Comparison with pre-millennial ranges shows an increase in Staphylococcus which was previously reported in less than 20% of cases. 11,13,28 The emergence of Staphylococcus as a leading cause of IE in LMICs, a trend that was also previously noted in HICs, may reflect medical technology advances, increased hospital contact and increasing comorbidities. 9,34,35 Consistent with these factors, it is noteworthy that only UMIC studies reported Staphylococcus as the leading cause of IE, accounting for up to 50% of cases.…”

Section: Staphylococcusmentioning

confidence: 81%

“…26 Overall, this range of underlying RHD in IE represents a decline from the 45-80% reported in earlier (pre-2000) LMIC studies. 10,11,13,27,28 Compared to HICs however, these findings are remarkable in that RHD is identified in only 3% of IE cases. 1 This is likely because the prevalence of RHD is disproportionately high in LMICs, 29,30 which bear 79% of the global RHD burden.…”

Section: Underlying Cardiac Conditionsmentioning

confidence: 96%

“…9 Reports from LMICs that mirror this epidemiology and treatment patterns are predominantly from before the turn of this millennium and consequently, may not reflect the current state of IE in LMICs. [10][11][12][13][14] The prevalence of RHD remains disproportionately high in LMICs, while uncorrected CHD persists in the poorest of these settings due to limited access to cardiac surgery. 15,16 It is therefore expected that RHD and CHD remain significant underlying cardiac conditions for IE; however, economic improvement in lower-middle income and upper-middle income countries has led to medical progress which may have introduced additional IE risk factors for these populations, and altered the spectrum of causative microorganisms.…”

Section: Infective Endocarditis In Low-and Middle-income Countries Inmentioning

confidence: 99%

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Infective Endocarditis in Low- and Middle-Income Countries

et al. 2017

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Key Points Staphylococcus is an increasingly important cause of IE in LMICs, and is the leading cause of IE in UMICs  RHD remains the major underlying cardiac pathology of IE in LMICs, identified in almost half of reported cases  The rate of microorganism non-identification is high, reaching up to 60% of IE cases in LMICs, and hampering diagnosis and treatment  Rates of access to surgery in UMICs for complicated IE are as high as in HICs, but remain dismal in lower-middle income countries SynopsisInfective endocarditis (IE) is a rare, life-threatening disease with a mortality rate of upto 25% and significant debilitating morbidities. Although much has been reported on contemporary IE in high income countries, conclusions on the state of IE in low and middle income countries (LMICs) are based on studies conducted before the year 2000. Furthermore, unique challenges in the diagnosis and management of IE persist in LMICs. This article is a review of IE studies conducted in LMICs documenting clinical experiences from the year 2000 to present. We present the causes of IE, management of patients with IE and the prevailing challenges in diagnosis and treatment of IE in LMICs.

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Section: Staphylococcusmentioning

confidence: 81%

Section: Underlying Cardiac Conditionsmentioning

confidence: 96%

Section: Infective Endocarditis In Low-and Middle-income Countries Inmentioning

confidence: 99%

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Infective Endocarditis in Low- and Middle-Income Countries

et al. 2017

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“…Intracranial IAs are less common (2-4% of endocarditis cases) but they produce potentially devastating neurological complications such as intracerebral or subarachnoid hemorrhage [9][10][11]. Since IAs can be clinically silent and some of them could resolve by antibiotic therapy, actual incidence of IAs is considered to be higher than the ones reported in the literatures [12].…”

Section: Discussionmentioning

confidence: 99%

Significance of the T2*-weighted gradient echo brain imaging in patients with infective endocarditis

Morofuji

Morikawa

Tateishi

et al. 2010

Clinical Neurology and Neurosurgery

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“…Previous retrospective studies have analyzed children and adults as a single group and it is difficult to distinguish clinical variables that are specific to children [8,9]. In order to optimize medical and surgical management in children with endocarditis and stroke, it is important to identify factors correlated with poor or improved outcome.…”

Section: Introductionmentioning

confidence: 99%

Pediatric Endocarditis and Stroke: A Single-Center Retrospective Review of Seven Cases

Venkatesan

Wainwright

2008

Pediatric Neurology

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The approach to the acute management of stroke in children with infective endocarditis is limited by the paucity of published data on their clinical course and outcome. We conducted a retrospective study at an urban tertiary care academic center to characterize the clinical course of seven pediatric patients with endocarditis and subsequent cerebral infarct. Among 115 patients with endocarditis, a stroke occurred in seven. Four patients had congenital heart disease. In 6 patients, the stroke was in the distribution of the middle cerebral artery and there was no preference for left or right hemisphere. The most common presenting symptom was focal weakness. Three patients had mycotic aneurysms, all of which were successfully repaired. Two patients were placed on aspirin therapy with no adverse effects. All patients survived but neurological recovery was variable. The two youngest patients (3 and 14 weeks of age) had the longest periods of hospitalization and had the most severe neurologic impairment. These findings suggest that children may have better outcome than adults after stroke secondary to bacterial endocarditis. Routine surveillance for mycotic aneurysms in patients with new neurological deficits and the use of aspirin should be considered in the medical management.

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Characteristics of infective endocarditis in a developing country-clinical profile and outcome in 192 Indian patients, 1992–2001

Cited by 100 publications

References 33 publications

Infective Endocarditis in Low- and Middle-Income Countries

Infective Endocarditis in Low- and Middle-Income Countries

Significance of the T2*-weighted gradient echo brain imaging in patients with infective endocarditis

Pediatric Endocarditis and Stroke: A Single-Center Retrospective Review of Seven Cases

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