Infective endocardities at autopsy in Muhimbili Hospital: A 22 years retrospective study

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University of Dar es Salaam
A retrospective study of 45 autopsy cases of infective endocartis (IE) in Muhimbili hospital Dar Es Salaam is presented. This study covers a period of 22 years between 1954 and 1975. IE represented about 4.4 percent of the clinical autopsy population and roughly 15.3 percent of those who died of cardiovascular problems in this period. Males were slightly more frequent than females, the sex ratio being 2.8:1 in favour of males. The peak age incidence was found in the groups between 30 and 54 years, the youngest being nine months and the oldest being 74 years. It was not possible to get accurate data about the duration of the disease from many of the patients. In 31 percent the duration was less than seven days and in about 21 percent the duration was more than 52 weeks. Cardiomegaly with congestive heart failure (CHF) was present in 55.5 percent of the cases. Congenital Heart Disease (CHD) with Infective endocarditis (IE) was not seen. Disease of the mitral valve was present in 29 of the cases while the aortic valve was diseased in 21 cases. Mitral stenosis was diagnosed more frequently than insufficiency, whereas the opposite was true for the aortic valve. Mural endocarditis was present in seven cases, while in 15 cases the disease probably started on previously normal valves. Sequelae of chronic rheumatic valvular disease still remain the most frequent predisponsing factor of IE in this series, being present in about 55.5 percent of the cases. Complications due to embol were present in 67 percent, the kidneys, spleen, central nervous system (CNS) and lungs being affected in that order of frequency. Two cases of myocardial infarction secondary to coronary embolism were found. Fever, gastrointestinal complaints, dyspnea and chest pain were the most frequent complaints. Toxic encephalopathy (Acute brain syndrome) had been present in 26.7 percent. Mitral valvular murmurs had been diagnosed in 17.8 percent and aortic valvular murmurs in 13 percent. Gram negative bacilli were isolated in 55.5 percent of the cases while stretococcuspyogenes and streptococcus viridans were each isolated in 14.8 percent. Culture was negative in 22.8 percent. CHF was considered the major cause of death in 55.5 percent. CNS involvement was present in 10 (22.2 percent) cases. A possible cause of death was found in 79.9 percent of the cases. There is urgent need to identify and study all cases of IE with a view of documenting its causes and change of its patterns if there are any in our environment.
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Endocardities, Heart
Gabone, R.M (1980) Infective endocardities at autopsy in Muhimbili Hospital: A 22 years retrospective study, masters dissertation, University of Dar es Salaam. Available at (