INFECTIVE ENDOCARDITIS: A lO-YEAR STUDY IN SHIRAZ UNIVERSITY HOSPITALS

The medical records of all patients discharged with the diagnosis of "infective endocarditis", "subacute bacterial endocarditis (SBE)," "acute bacterial endocarditis (ABE)," and "bacterial endocarditis" from March 1977, to February 1987, were reviewed. 84 cases fulfilled the criteria of endocarditis. Sixty-one percent were male and the mean age was 25.7 years. 57% were culture-negative and among culturepositive cases, S. aureus was predominant (44%). Culture-positivity was associated with higher mortality. Multiple valve involvement was most common (36%). Among fatal cases, mitral involvement was most common (33%) and mitral involvement was associated with the highest mortality (22%). 92% of the patients showed evidence of abnormal heart before development of endocarditis, rheumatic heart disease being the most common (73%). The mortality rate was 21 % and CNS complications were the major cause of death. Although much of our results are consistent with published data, there are some major differences. Points which might explain these differences are: high incidence of rheumatic heart disease among Iranians, delay in seeking medical care, indiscriminate use of antibiotics prior to adequate cultures, and shortcomings in laboratory techniques.