Infective endocarditis at autopsy in Northern India. A study of 120 cases.

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Abstract
Pathologic data on 120 [human] autopsied cases of infective endocarditis are presented. They constitute 1.8% of total 6700 and 6.3% of 1900 cardiac autopsies over 16 yr. Ninety percent of patients were < 40 yr old, 42.5% had no preexisting heart disease, 33.3% had previous valvular disease, mainly rheumatic, and 24.2% had congenital heart disease. Of the cases, 26.6% had lesions on the right side of the heart, 16.6% exclusively so. Cardiac complications were infrequent while systemic infarcts were found in > 80% of cases. A route of infection was detected only in 24.1% of the cases, puerperal sepsis being the commonest. Staphylococci were the responsible bacteria in 18 of 28 cases in which microbiologic data were available. There were only 2 cases with infective lesions on prosthetic valves, both fungal. The pattern of infective endocarditis in this and other reports from India and Africa differs from that in the West in many respects, including the younger age of these patients, significant rheumatic background disease, absence of narcotic addicts and of degenerative heart disease, and lower incidence of cardiac complications.