Clinical, Bacteriologic and Echocardiographic Evaluation of Infective Endocarditis in Ankara, Turkey

Abstract

This study consists of a retrospective evaluation of microbiologic, echocardiographic, and clinical characteristics of patients with infective endocarditis seen at Türkiye Yüksek Ihtisas and SSK Ihtisas Hospitals during the previous 5 years to provide a basis for comparison with other series. The study was performed retrospectively. The mean age of the patient population, which consisted of 74 cases, was considerably low (24.6+/-12.3 yr). The majority of the patients were male (male/female = 1.96). Rheumatic valvular disease was the underlying cardiac pathosis in 66% of the cases. Congestive heart failure, embolic episodes, and mortality were more frequent among those with echocardiographically demonstrable cardiac vegetations. The microbiologic profile was considerably different from that of other series. In addition, this population showed a higher rate of congestive heart failure compared to other series. The patients with infective endocarditis in this series in the previous 5 years were found to be different from series reported from western countries.

Rheumatic Heart Disease in Asia

“…This interest in endocarditis persisted: An additional 8 studies [37][38][39][40][41][42][43][44][45][46][47][48] from Asia were found during the preparation of the present report (Table 3). The recent studies from India, Turkey, and Lebanon all found that rheumatic heart disease was the most common underlying factor in endocarditis (range 33% to 66%), 41,44,45,47 whereas studies from Hong Kong and Thailand found rheumatic heart disease in 18% and 12% of cases, respectively, 42,46 and a study from Singapore found rheumatic heart disease in only 4% of endocarditis cases. 48 …”

Clinical Profile and Management in Children with Rheumatic Heart Disease in a Tertiary Cardiac Care Center of Nepal

“…The association of this deadly and potentially fatal complication with RHD is almost present only in Asian countries. 9 Studies from India and Turkey have shown RHD to be the most common cause for infective endocarditis representing 33% to 66% of cases 16,17,18 whereas in Singapore RHD was responsible for only 4% of endocarditis cases. 19 RHD is the second commonest cause of open heart surgery in Nepal.…”

Achados clínico-laboratoriais de uma série de casos com endocardite infecciosa

“…Alguns autores o têm considerado de baixa sensibilidade como método para diagnóstico de EI em pacientes com poucos critérios clínicos da doença 9,12 , porém outros avaliam que o uso da ecocardiografia na avaliação de criança com suspeita clínica de endocardite tem ampla aplicação, principalmente por que, em pediatria, o eco transtorácico oferece excelente campo 4,11 . Neste estudo, alteração característica ao exame foi um dos critérios de inclusão.…”

“…A microbiologia das endocardites infecciosas em crianças tem mudado consideravelmente, conforme relato de alguns autores, com o decréscimo das infecções devido ao Streptococcus viridans, com surgimento de novos agentes etiológicos, incomuns em décadas passadas, e como fator importante desta mudança está a maior sobrevida de crianças com cardiopatia congênita, e também o aumento da incidência de infecções estafilocócicas 6,11,12 . Este fato também foi por nós observado, e os resultados demonstraram que endocardite infecciosa foi freqüente entre crianças abaixo de dois anos de idade e naquelas com cardiopatias congênitas.…”

“…Em crianças, o exame de ecocardiografia transesofágica tem uso limitado, razão pela qual utiliza-se rotineiramente o ecocardiograma transtorácico 2,9,10 . Como a endocardite infecciosa em crianças é uma entidade heterogênea, seu manejo requer também cuidadosos critérios baseados nas evidências clínicas e laboratoriais, além dos critérios ecocardiográficos 11,12 .…”