Infective Endocarditis In Children With Congenital Heart Disease

Introduction The epidemiology, clinical features, treatment and outcomes of pediatric patients with congenital heart disease (CHD) and infective endocarditis (IE) were reviewed.Methods Retrospective reviews of medical records from the Children's Hospital of Zhejiang university school of medicine were done to identify patients with congenital heart disease and infective endocarditis from January 1992 to January 2006. Basic demographic and clinical data were gathered and reviewed. Data analysis was performed using SPSS for Windows.Results During this period, 45 patients were diagnosed as congenital heart disease with infective endocarditis (29 males and 16 females, mean age 6.4±4.3 years) . Ventricular septal defect (25 case, 55.6%) and patent ductus aiteriosus (9 case, 20.0%) were the commonest underlying heart disease. Fever (45 case,100.0%), anemia (33 case, 73.3%) , splenomegaly (18 case, 40.0%) were the common clinical findings. Vegetation was found in 29 (64.4%) patients by TTE . Blood cultures were positive in 26 (57.8%) episodes and the most common microorganisms were streptococci(50%) and staphylococci (38.5%, Staphylococcus aureus in 26.9%). Frequentcomplications were congestive heart failure (37.8%) and embolic events (15.6%).Surgery was common in patients with congenital heart disease and infectiveendocarditis (25 case, 55.6%), when whose vegetation and congestive heart failurecould not be controlled by medicine.Conclusions Infective endocarditis (IE) is common in children with ventricularseptal defect and patent ductus arteriosus. The most common microorganism isstreptococci and staphylococci. Frequent complications were congestive heartfailure and embolic events. Operation can be done in patients whose vegetation andcongestive heart failure could not be controlled by medicine.