BACTERIAL-ENDOCARDITIS IN MOROCCO

This retrospective study was based on 157 cases of infectious endocard itis observed in the Cardiology department of Ibn Rochd Hospital in Ca sablanca between January 1983 and December 1994. The mean age of the p atients was 27.5 years (11 to 65 years) with a male predominance (62.8 %). Infectious endocrditis was secondary to rheumatic valvular heart d isease in 63.% of patients and was primary in 29.9% of cases. Mitral o r mitroaortic valve involvement was clearly predominant. A portal of e ntry of the infection was identified in 63% of patients. It was dental in 64% of cases. Blood cultures were positive in 42% of cases with a predominance of unclassifiable Streptococci (37.8%) and coagulase-nega tive Staphylococci (25.7% of cases). Echocardiography was very useful, particularly in the presence of negative blood cultures. It demonstra ted specific lesions of infectious endocarditis in 73.2% of cases and revealed very large, mobile vegetations in every case complicated by s ystemic embolism. The clinical course was complicated by heart failure (47.8%), renal failure (14.6%) or neurological lesions (11.5%). The g lobal mortality was 28.7%, related to refractory heart failure in most cases.