COMPARISON OF ECHOCARDIOGRAPHIC FEATURES OF PATIENTS WITH INFECTIVE ENDOCARDITIS IN HIV-POSITIVE TUBERCULOSIS PATIENTS AND HIV-NEGATIVE TUBERCULOSIS PATIENTS
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2017, Vol 6, Issue 78
Abstract
BACKGROUND Infective endocarditis (IE) is an infection of the endocardial surface of the heart structures, and is caused by the microbial bacterial organisms and fungal infection that occurs as a result of colonisation of the endothelium by microorganisms. The following study intended to evaluate the echocardiographic features of infective endocarditis on immunocompromised patients. The aim of this study is to compare the echocardiographic features of patients with infective endocarditis in HIV-positive tuberculosis patients and HIV-negative tuberculosis patients. MATERIALS AND METHODS This was a retrospective descriptive observational study, conducted over two years from April 2015-April 2017 of all the infective endocarditis patients using the modified Duke criteria for diagnosing IE. Patients having PTB and HIV are included in the study. All tuberculosis patients are divided into two groups based on the HIV status. RESULTS During this period of two years, 91 patients were screened for infective endocarditis. 77 satisfied the criteria for a definite diagnosis of IE. Most patients had advanced valve disruption with heart failure. 38 patients were diagnosed as pulmonary tuberculosis or extrapulmonary based on molecular testing. Of them, 26 patients were HIV-positive tuberculosis patients, and 8 were HIV-negative tuberculosis patients. Most of the clinical features in the two groups of patients were similar. Vegetations were the predominant finding in 34 patients on echocardiography. Vegetations were found in 26 of the HIV-positive pulmonary tuberculosis patients, and in 8 of the HIV-negative tuberculosis patients. This clearly shows HIV and TB co-infection leads to significant increased incidence of infective endocarditis when compared to tuberculosis itself. The leaflet aneurysms appeared larger in size in the HIV-positive tuberculosis patients (0.92 cm depth x 0.91 cm width) when compared to the smaller-sized aneurysm in the HIV-negative patients (0.14 cm depth x 0.6 cm width) which is statistically significant. CONCLUSION There was no difference in the clinical presentation of infective endocarditis between HIV-positive and HIV-negative tuberculosis patients. Vegetations were more common in HIV-positive cohort when compared to HIV-negative cohort. Leaflet aneurysms were also more common in the HIV-positive tuberculosis patients when compared to HIV-negative tuberculosis patients.
Authors and Affiliations
Kalyan Kumar P. V, Ramakrishna Gorantla
Keywords
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- EP ID EP268042
- DOI 10.14260/jemds/2017/1203
- Views 68
- Downloads 0
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