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Review
. 2020 Apr;10(2):252-261.
doi: 10.21037/cdt.2019.06.03.

Infective endocarditis in South Africa

Alfonso Jan Pecoraro  1 , Anton Frans Doubell  1
Affiliations
Review

Infective endocarditis in South Africa

Alfonso Jan Pecoraro et al. Cardiovasc Diagn Ther. 2020 Apr.

Abstract

Infective endocarditis (IE) is defined by infection of either a native or prosthetic heart valve, endocardial surface or any cardiac prosthetic device. It is a disease of both the developed and developing world, although IE has evolved in the developed world to a disease markedly different to the disease encountered in the developing world. IE in developed nations is mainly a disease of older patients with degenerative heart valve disease or cardiac prosthetic material, with virulent Staphylococci the most common causative organism. Data regarding the epidemiology of IE in South Africa, a developing country, is limited. The available data suggest it is still a disease of younger patients with rheumatic heart disease (RHD), associated with penicillin-sensitive Streptococcal infection. Although novel diagnostic techniques and improved therapeutic options has emerged, the 1-year mortality rate has remained high in both the developed and developing world at around 30%.

Keywords: Infective endocarditis (IE); rheumatic heart disease (RHD); valvular heart disease.

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Conflict of interest statement

Conflicts of Interest: Both authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/cdt.2019.06.03). The series “Cardiovascular Diseases in Low- and Middle-Income Countries” was commissioned by the editorial office without any funding or sponsorship. The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Vegetations (arrow) visible on the atrial surface of the mitral valve within the jet of mitral regurgitation.
Figure 2
Figure 2
Apical four chamber view of a patient with confirmed tuberculous endocarditis with aneurismal perforation of anterior mitral valve leaflet (arrow).
Figure 3
Figure 3
“Kissing vegetations” (arrows) on adjacent leaflets of the mitral valve typical of NBTE. NBTE, non-bacterial thrombotic endocarditis.
See this image and copyright information in PMC

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