Evaluation of pediatric patients with infective endocarditis: An 11-year experience Çocukluk yaş grubunda infektif endokarditlerin deǧerlendirmesi: 11 Yillik deneyimin sunumu


Hizli Ş. , Bilgiç A.

Turk Kardiyoloji Dernegi Arsivi, cilt.33, ss.141-148, 2005 (SCI Expanded İndekslerine Giren Dergi) identifier

  • Cilt numarası: 33 Konu: 3
  • Basım Tarihi: 2005
  • Dergi Adı: Turk Kardiyoloji Dernegi Arsivi
  • Sayfa Sayıları: ss.141-148

Özet

Objectives: We retrospectively reviewed patients with infective endocarditis (IE). Study design: Thirty-three patients (13 girls, 20 boys; mean age 8.6±4.3 years; range 9 months to 17 years) were treated for IE at Hacettepe University İhsan Doǧramaci Children's Hospital during an 11-year period. This retrospective evaluation included predisposing factors, signs and symptoms on presentation, physical examination and laboratory findings, treatment modalities, and the results. Results: Twenty-two (66.7%) and 11 (33.3%) patients had congenital and rheumatic heart diseases, respectively. Eleven patients (50%) with congenital heart disease had a history of previous surgery, six (54.6%) of whom were operated on two months before the diagnosis of IE. Antibiotics were used in 15 patients (45.5%) for various periods before a week to the diagnosis. Transthoracic echocardiography showed vegetations in 29 patients (87.9%). Blood cultures were positive in 54.6% of the patients, with gram-negative bacteria accounting for the majority of cases. Nineteen patients (57.6%) received medical therapy, while 14 patients (42.4%) were treated both medically and surgically. Echocardiographic findings were consistent with intraoperative findings. There were no deaths among surgically treated patients, whereas five patients (26.3%) died while on medical treatment, all of whom had cerebral, pulmonary, and/or renal emboli. The most frequent complications were congestive heart failure (36%), glomerulonephritis (27%), and peripheral embolism (21.2%). Conclusion: Timely diagnosis and surgical treatment are of utmost importance in IE patients, particularly in those in whom gram-negative and staphylococcal bacteria may considerably increase morbidity and mortality.