Cardiology Department, Road of Rabat, Mohamed VI University Hospital Center Tanger-Tetouan-Al Hoceima, Abdelmalek Essaadi University, Km 17, BP 398 - Gzinaya, Tangier, Morocco.
BMC Infect Dis. 2024 Jul 15;24(1):698. doi: 10.1186/s12879-024-09436-4.
Infective endocarditis is a rare but potentially severe disease, associated with significant morbidity and mortality. Our study aims to describe the epidemiology and management aspects of endocarditis in northern Morocco and compare it with international management guidelines.
This is a retrospective study involving all patients hospitalized in the cardiology department of the University Hospital of Tangier for infective endocarditis over a period of 4 years and 7 months, from May 2019 to February 2024.
Eighty patients were hospitalized for IE during the study period. The average age of the patients was 46 years, with an even sex ratio. IE concerned native valves in 77% of cases, mechanical prostheses in 19% of cases, and on bio prostheses in 4%. The average diagnostic delay was 25 days. Blood cultures were negative in 59% of cases. The predominant infective microorganism was the bacteria Staphylococcus (65.6%). Imaging results showed vegetations in 76.3% of cases, predominantly on the mitral valve (39.3%), followed by the aortic valve (21.3%). The main complications included heart failure (51.2%), peripheral arterial embolisms (22.5%) and splenic infarction (17.5%). Management wise, the most commonly used antibiotic therapy was a combination of ceftriaxone and gentamicin. Clinical and biological improvement was observed in 70% of cases, with a mortality rate of 12.5%. Twelve patients underwent surgery (15%). Urgent surgery was indicated in 66,7% of the operated patients.
Our study highlights the challenges in managing infective endocarditis in northern Morocco. The prognosis of infective endocarditis can be improved through multidisciplinary management within the implementation of an Endocarditis Team.
感染性心内膜炎是一种罕见但潜在严重的疾病，与较高的发病率和死亡率相关。我们的研究旨在描述摩洛哥北部感染性心内膜炎的流行病学和治疗方面，并与国际治疗指南进行比较。
这是一项回顾性研究，纳入了 2019 年 5 月至 2024 年 2 月期间在丹吉尔大学医院心内科因感染性心内膜炎住院的所有患者。
在研究期间，有 80 名患者因 IE 住院。患者平均年龄为 46 岁，男女比例均衡。IE 涉及 77%的原生瓣膜、19%的机械瓣膜和 4%的生物瓣膜。平均诊断延迟为 25 天。59%的病例血培养阴性。主要感染微生物为细菌葡萄球菌（65.6%）。影像学结果显示 76.3%的病例存在赘生物，主要位于二尖瓣（39.3%），其次是主动脉瓣（21.3%）。主要并发症包括心力衰竭（51.2%）、外周动脉栓塞（22.5%）和脾梗死（17.5%）。在治疗方面，最常用的抗生素治疗是头孢曲松和庆大霉素联合治疗。70%的病例临床和生物学改善，死亡率为 12.5%。12 名患者（15%）接受了手术。在手术患者中，66.7%的患者需要紧急手术。
我们的研究强调了在摩洛哥北部管理感染性心内膜炎所面临的挑战。通过多学科管理并实施心内膜炎团队，可以改善感染性心内膜炎的预后。
