| Objective: To investigate the clinical characteristics of infective endocarditis (IE) in children.Methods: The clinical features of 110 IE children patients who were treated in First hospital of Jilin University from January 1980 to December 2010 were retrospectively analyzed.Results:①There are 57 boys and 53 girls in our record, and the ratio is 1.1 : 1. In the data, the youngest is 2 months, the oldest is 18 years old, mean age is 6.669±2.118, including 8 patients who were less than 3 years old,and 102 patients who were more than 3 years old.②In the 110 cases, there were 77 patients resulting from congenital cardiovascular diseases, 10 patients from rheumatic heart diseases, 8 patients from dilated cardiomyopathy, 1 patient from hypertrophic cardiomyopathy and 14 patients without underlying diseases.③Clinical manifestations were: fever (105 cases, 95.5%), cardiac insufficiency (75 cases, 68.1%), anaemia (73 cases, 66.4%), splenomegaly (49 cases, 44.5%), heart murmurs change (19 cases, 17.3%), arterial embolism(47 cases, 42.6%).④Positive blood culture was found in 39 cases (35.5%), the main pathogenic micro-organisms including: Strep tococcus viridans (17 cases, 46.6%), staphylococcus (7 cases, 17.9%) ; with the respect of previous administration of antibiotics, there was significant difference between the blood culture-negative group and culture-positive group, and it was significantly higher in blood culture-negative group (76.1%) than in blood culture-positive group (38.5%, P<0.05).⑤ Vegetation was found during echocardiography in 94 cases (85.5%), The concerned heart valves included aortic valve, mitral valve, tricuspid valve.⑥20 antimicrobial agents were used in the managenment of this disease in the 110 patients, including cephalosporin group (11), penicillin group (4), carbapenems group (2), macrolides group (2), glycopeptides group (1) etc. For managenment of this disease, only one antibiotic agent was used in 15 (13.6%) patients, two antibiotic agents in 41 (37.3%) patients, three antibiotic agents in 24 (21.8%) patients, four antibiotic agents in 20 (18.2%) patients, five antibiotic agents in 10 (9.1%) patients. Duration of antibiotic treatment was from 7 days to 82 days, less than 2 weeks in 7 (6.3%) patients, 2 weeks to 4 weeks in 30 (27.3%) patients, 4 - 6 weeks in 52 (47.3%) patients, more than 6 weeks in 21 (19.1%) patients. The cure rate of IE was 70.9%, among which, 56 patients were cured simply by antibiotics (71.8%) and 30 patients were cured by anti-infection combining operation (28.2%), and 8 patients died.Conclusion: (1) Congenital cardiovascular disease is the most common in the basic heart diseases that cause IE, and rheumatic heart disease takes the second place. (2) Blood culture and echocardiography are helpful for the diagnosis of IE, and echocardiography has more practical significance in clinical diagnosis. (3) The mainly pathogenic micro-organism of pediatric infective endocarditis are streptococcus viridans and staphylococcus, and the distribution of the pathogens has diversified trend.
|
PDF Full Text Request