J Med Assoc Thai 2005; 88 (9):12

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Infective Endocarditis in Pediatric Patients: An Eighteen-Year Experience from King Chulalongkorn Memorial Hospital
Lertsapcharoen P Mail, Khongphatthanayothin A , Chotivittayatarakorn P , Thisyakorn C , Pathmanand C , Sueblinvong V

Objectives: 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.
Material and Method: From January 1987 to December 2004, 57 pediatric patients; 28 females and 29males, 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.
Results: 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 in30 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 > 10 mm had a significant higher incidence of embolic events.
Conclusion: 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.

Keywords: Infective endocarditis, Pediatric, Complication


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