Two-dimensional echocardiographic observations in patients with clinical diagnosis of active infective endocarditis at Kenyatta National Hospital
Abstract
The sensitivity and clinical relevance Qf 2-dimensional echocardiographic
presence of vegetations were examined proepectively in
patients with cl nical diagnosis of active infective endocarditis
at Kenyatta National Hospital, NairObi.
A pattern of echocardiographic vegetations was present in
45% of the 40 patients diagnosed clinically to have active
infective endocarditis.
The major criteria for clinical diagnosie in these 40 patients
included the presence of fever (manifested by chills, sweating,
shivering and rigors) 8o%, Toxaemia (manifested by malaise,
tiredness, weakness, anorex:a with generalised aches and pains)
77.5%, Cardiac murmurs 100%, congestive cardiac failure 80%
and Pyrexia (Temp> 3aoe) 62.5%. 77.5% of the cases had
rheumatic valvular heart disease. Blood cultures were positive
in 37.1% of the patients, with staphylococCi being the commonest
isolate. Only 30.8% of patients with bacteriologically proven
endocarditis had vegetations on ultrasound whereas 54.5% of
patients with negative blood cultures had vegetations at
ultrasound. 47.5% of thE patients had antibiotic therapy
prior to diagnosis, which was significantly correlated to
the presence of bacteriologically negative cultures.
The case fatality rate was 37.5% and was significantly related
to the presence of severe CCF, and Renal insufficiency.
The presence of vegetations on ultrasound in this series had
no prognostic implications in so far as CCF, major emboli
or death were concerned.
Citation
Degree of Master of Medicine (Internal Medicine)Publisher
University of Nairobi Department of Medicine
Description
A dissertation submitted in part fulfilment for the Degree
of Master of Medicine (Internal Medicine) at the
University of Nairobi, 1990.