Infective Endocarditis in Morocco’s Souss-Massa Region: Epidemiological Trends

Infective endocarditis (IE) remains a life-threatening condition with high morbidity and mortality despite advances in diagnosis and therapy. Its epidemiology varies across regions, reflecting demographic and socioeconomic factors. This study aimed to describe the epidemiological profile of IE in the Souss Massa region of Morocco. We conducted a retrospective descriptive study in the cardiology department of the Souss Massa University Hospital from September 2022 to May 2025. Twenty-six patients aged ≥16 years, fulfilling the modified Duke criteria and investigated with transthoracic and/or transesophageal echocardiography, were included. The mean age was 46.2 years (25–75), with a male predominance (sex ratio 1.6). Predisposing cardiac conditions were present in 80.7% of patients, mainly rheumatic or degenerative valvulopathies (34.6%) and congenital heart disease (19.2%). Prosthetic valve endocarditis accounted for 11.5% of cases, and device-related infections for 3.8%. Febrile dyspnea was the most common presenting feature (69.2%). Valvular involvement predominantly affected the left heart: the mitral and aortic valves were each involved in 30.7% of cases, while combined mitro-aortic involvement was found in 19.2%. Right-sided endocarditis occurred in 11.5% of cases, and one exceptional case of biventricular involvement with a right atrial–aortic fistula was documented. Compared with international registries, patients in our series were younger, reflecting the ongoing burden of rheumatic heart disease in Morocco. These findings emphasize the need for reinforced prevention strategies and the development of national registries to improve the management of infective endocarditis in low- and middle-income settings.