Clinical Characteristics Of Infective Endocarditis Associated With Congenital Heart Disease

Objective:To study the clinical characteristics,congenital types,p athogenic characteristics and risk factors of death in pediatric congeni tal heart disease(CHD)associated with infective endocarditis(IE),upda te the understanding of the disease,and provide reference for reducin g mortality and clinical diagnosis and treatment.Methods: Review clinical characteristics,congenital types,pathog enic characteristics,therapeutic effects and risk factors of death in pe diatric congenital heart disease(CHD)associated with infective endoca rditis(IE)of our hospital during June 2006 and June 2018.Results: Among the 48 children,Male is more than female(M/F=1.18:1);the median age was 5 years and 5 months,of which 29 c ases were older than 3 years old and the remaining were less than 3years old.There were 38 cases have fever in this group,with mode rate to high fever,and 24 cases with body temperature greater than 39.0 °C.Other clinical manifestations were cough(33 cases),shortn ess of breath(22 cases),fatigue(11 cases),dyspnea(3 cases),and palpitations(2 cases).The most common signs were heart murmu rs(33 cases,68.8%),followed by liver enlargement(31 cases,64.6%),splenomegaly(11 cases,22.9%).The most common complications w ere cardiac insufficiency(18 cases,38.8%),microscopic hematuria,pr oteinuria(10 cases,20.8%),and embolic events(10 cases,20.8%).A mong the 48 patients,the largest proportion of CHD was VSD(10 ca ses,20.8%),followed by VSD with ASD(8 cases,16.7%).The sensitivi ty of transthoracic echocardiography is 83.3%.Most cases of CHD ass ociated IE are caused by Staphylococcus aureus(5 cases,27.8%).The re were 26 patients received surgery,During the follow-up period,9 patients died.The cause of death was mainly severe heart failure.Un ivariate logistic regression analysis of the study showed that cardiac dysfunction,embolization,surgical treatment,and C-reactive protein >100 were associated with death(P<0.05),and cardiac dysfunction wa s independent risk factor of death in children with CHD and IE(P<0.05).Conclusions:To study the clinical characteristics of 48 children with CHD combined with IE,Showed that VSD was the most comm on type of CHD,Most cases of CHD associated IE are caused by St aphylococcus aureus.The cardiac dysfunction,embolization,surgical tr eatment,and C-reactive protein >100 were associated with death and cardiac dysfunction was independent risk factor of death in children with CHD and IE.Early diagnosis of CHD combined with IE,ration al use of antibiotics,combined with early surgery can achieve good t herapeutic results.Actively analyze the clinical characteristics,pathoge ns and drug resistance of IE patients to create surgical conditions as soon as possible,and Precautions should be taken according to the re levant risk factors so as to reduce the incidence of death in patients with infective endocarditis.