Infective endocarditis (IE) is an uncommon pathology, but remains worrying and carries heavy morbidity and mortality.

To study epidemiological, clinical, therapeutic and evolving aspects of IE.

This was a descriptive, analytical and retrospective study carried out in Sahloul cardiology department, from January 2010 to June 2020. We collected 74 cases of IE whose diagnosis was certain or probable according to the criteria of modified Duke.

The average age was 40.67 years, with a male predominance (sex ratio=5.21). Infective endocarditis was on native valve in 59.45% of cases, in 17.56% on prosthetic valve, in 21.62% on congenital heart disease and 1.35% on implanted cardiac devices. The underlying heart disease was rheumatic in 31.80% of patients. The entry point was dominated by the oral and dental origin (24.32%). Fever was the main functional sign (95.94%). Blood cultures were positive in 40.54% of cases, isolating a Streptococcus in 21.62% and a Staphylococcus in 14.86%. Transthoracic echography showed: adenoids (83.78%), cardiac abscess (12.16%), valve perforation (8.10%), cord rupture (8.10%) and para-prosthetic insufficiency (5.40%). The outcome under antibiotic treatment was favorable in 12.16% of cases. The appearance of heart failure, secondary locations and neurological complications were noted respectively in 43.24%, 31.08% and 28.37% of cases. Surgical treatment was indicated in 68.91% of cases, carried out during the active phase in 38.18% because of hemodynamic and/or septic alteration. Hospital mortality was at 27.20%, the predictive factors of which were heart failure (P=0.022), neurological complications (P=0.021) and definite endocarditis (P=0.005).

IE is a serious disease. Mortality remains high despite considerable progress in diagnosis, microbiology and treatment.