Infective endocarditis in pediatric patients: an eighteen-year experience from King Chulalongkorn Memorial Hospital

Lertsapcharoen, P.; Khongphatthanayothin, A.; Chotivittayatarakorn, P.; Thisyakorn, C.; Pathmanand, C.; Sueblinvong, V.

Journal of the Medical Association of Thailand 88 Suppl. 4: S12-S16

2005


ISSN/ISBN: 0125-2208
PMID: 16622995
Document Number: 9175
To review the clinical features and outcome of the pediatric patients diagnosed with infective endocarditis (IE) at King Chulalongkorn Memorial Hospital over an 18-year period. From January 1987 to December 2004, 57 pediatric patients; 28 females and 29 males, age ranged from 2 months to 15 years, mean of 8.64 +/- 3.82 years, classified as "definite" IE according to the Duke criteria were reviewed. Of the 57 patients, 42 patients (74%) had underlying congenital heart diseases, 7 patients (12%) had underlying rheumatic heart disease, 8 patients (14%) had previously normal heart. Nine patients had history of previously palliative or corrective surgery. Blood cultures were positive in 26 patients (46%). Streptococci and staphylococci were the most commonly isolated organisms. Two-dimensional echocardiography demonstrated vegetations in 56 patients (98%). The location of the vegetations was in the right heart in 30 patients (54%) and in the left heart in 26 patients (46%). Complications occurred in 28 patients (49%). Common complications included congestive heart failure, cerebral emboli, septic shock, and mycotic aneurysm. The overall mortality was 11% (6 patients). By statistical analysis, vegetations in the left heart had a higher incidence of complication than that in the right heart. The vegetation size of > or =10 mm had a significant higher incidence of embolic events. The clinical features and outcomes of the present study have a similar pattern as the earlier studies. The rates of complications and mortality are still high.

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