Infective endocarditis in the Western Cape Province of South Africa: A three-year prospective study

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dc.contributor.authorKoegelenberg C.F.N.
dc.contributor.authorDoubell A.F.
dc.contributor.authorOrth H.
dc.contributor.authorReuter H.
dc.date.accessioned2011-05-15T16:17:47Z
dc.date.available2011-05-15T16:17:47Z
dc.date.issued2003
dc.description.abstractBackground: The last 50 years have seen major changes in the epidemiology of infective endocarditis (IE). Aim: To evaluate local patient characteristics, risk factors, clinical sequelae, microbiology, morbidity and mortality in patients with definite IE. Design: Prospective observational study. Methods: Over a three-year period, patients referred with probable IE were prospectively enrolled. All received a standardized diagnostic evaluation. Epidemiological data were documented; underlying risk factors for IE were sought. Initial evaluation and follow-up (to 6 months) included the documentation of vascular or immunological phenomena, morbidity and mortality. Results: Of 92 patients referred with probable IE, 47 had definite IE. These patients had a mean age of 37.7 years with a male predominance (1.6:1). Rheumatic heart disease was present in 36 (76.6%). Eight had prosthetic valves. Three had congenital heart disease, mitral valve prolapse or multiple central intravascular catheters, respectively. All denied the use of intravenous recreational drugs and only one tested seropositive for HIV. Renal involvement (59.6%) and clubbing (29.8%) were commonly observed. The 6-month mortality rate was 35.6%, while 44.7% needed valvular replacement. An aetiological diagnosis was made in 21, with viridans streptococci the most common isolate. Discussion: Infective endocarditis in the Western Cape of South Africa is a disease of younger adults, with a male predominance. Rheumatic heart disease is the major predisposing factor. Degenerative heart disease and intravenous drug abuse are not important risk factors. Our data do not support the notion that HIV infection is an independent risk factor for IE. Local mortality rates are much higher than recent international figures, as is the proportion of 'culture-negative' IE.
dc.description.versionArticle
dc.identifier.citationQJM - Monthly Journal of the Association of Physicians
dc.identifier.citation96
dc.identifier.citation3
dc.identifier.issn14602725
dc.identifier.other10.1093/qjmed/hcg028
dc.identifier.urihttp://hdl.handle.net/10019.1/14371
dc.subjectamoxicillin
dc.subjectbeta lactam antibiotic
dc.subjectcloxacillin
dc.subjectgentamicin
dc.subjectpenicillin G
dc.subjectrifampicin
dc.subjectvancomycin
dc.subjectadult
dc.subjectage distribution
dc.subjectalpha hemolytic Streptococcus
dc.subjectarticle
dc.subjectbacterial endocarditis
dc.subjectbacterium culture
dc.subjectbacterium isolate
dc.subjectcongenital heart disease
dc.subjectcontrolled study
dc.subjectdiagnostic test
dc.subjectepidemiological data
dc.subjectfemale
dc.subjectfollow up
dc.subjectheart disease
dc.subjectheart valve prosthesis
dc.subjectheart valve replacement
dc.subjecthuman
dc.subjectHuman immunodeficiency virus infection
dc.subjectimmunopathology
dc.subjectintravascular catheter
dc.subjectintravenous drug abuse
dc.subjectkidney disease
dc.subjectmajor clinical study
dc.subjectmale
dc.subjectmedical documentation
dc.subjectmicrobiology
dc.subjectmitral valve prolapse
dc.subjectmorbidity
dc.subjectmortality
dc.subjectpatient referral
dc.subjectpriority journal
dc.subjectprospective study
dc.subjectrheumatic heart disease
dc.subjectrisk factor
dc.subjectsex ratio
dc.subjectSouth Africa
dc.subjectvascular disease
dc.subjectAdult
dc.subjectEndocarditis, Bacterial
dc.subjectFemale
dc.subjectHumans
dc.subjectMale
dc.subjectMiddle Aged
dc.subjectProspective Studies
dc.subjectRheumatic Heart Disease
dc.subjectRisk Factors
dc.subjectSouth Africa
dc.titleInfective endocarditis in the Western Cape Province of South Africa: A three-year prospective study
dc.typeArticle
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