The changing pattern of infective endocarditis in childhood

Awadallah, Sami M.; Kavey, Rae-Ellen W.; Byrum, Craig J.; Smith, Frank C.; Kveselis, Daniel A.; Blackman, Marie S.

doi:10.1016/0002-9149(91)90717-y

Cited by 123 publications

(87 citation statements)

References 19 publications

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“…Previous case series have shown improved sensitivity in vegetation identification by echocardiography in patients with normal cardiac anatomy as opposed to those with complex CHD. 8,11 In our study, vegetations in patients with CHD and normal cardiac anatomy were identified by echocardiography at a similar rate (69% and 71%, respectively).…”

Section: Echocardiographysupporting

confidence: 65%

“…7 The sensitivity of echocardiography ranges from 51% to 67% in different case series. [8][9][10]15 In our study, the percentage of vegetations identified by echocardiography was 70%, with the majority involving the mitral and aortic valves in patients with CHD. Transesophageal echocardiography identified vegetations in 4 patients in whom transthoracic echocardiography had not detected a vegetation.…”

Section: Echocardiographymentioning

confidence: 95%

“…This trend in rheumatic heart disease has been shown in several other case series. 4,[8][9][10][11] A major risk factor for IE in patients with CHD is prior surgical intervention. In our study, there was a history of cardiovascular surgery in 34% of pa- …”

Section: Demographic Characteristics and Epidemiologymentioning

confidence: 99%

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Infective Endocarditis in the Pediatric Patient: A 60-Year Single-Institution Review

Johnson

Boyce

Cetta

et al. 2012

Mayo Clinic Proceedings

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Objective: To determine the epidemiology of infective endocarditis (IE) presenting in pediatric patients during a 60-year period at our institution. Patients and Methods: In this retrospective medical record review, we extracted demographic characteristics, diagnostic variables, and outcomes for patients less than 20 years of age diagnosed with IE from January 1, 1980, to June 30, 2011. We compared this cohort with a previously reported cohort of pediatric patients with IE from our institution diagnosed from 1950 to 1979. Results: We identified 47 patients (24 males; mean Ϯ SD age at diagnosis, 12.3Ϯ5.5 years [range, 1 day to 18.9 years]) who had 53 episodes of IE. The most common isolated organisms were viridans streptococci (17 of 53 episodes [32%]) and Staphylococcus aureus (12 of 53 episodes [23%]). Of the 47 patients, 36 (77%) had congenital heart disease, 24 of whom had cardiac surgery before their first episode of IE (mean Ϯ SD time to IE diagnosis after surgery, 4.2Ϯ3.2 years [range, 64 days to 11.3 years]). Fourteen patients (30%) required valve replacement because of valvular IE, and 16 (34%) had complications, including mycotic aneurysm, myocardial abscess, or emboli. Vegetations were identified using echocardiography in 37 of the 53 unique episodes of IE (70%). Endocarditis-related mortality occurred in 1 patient. Compared with the historical cohort, there were no differences in patient demographic characteristics, history of congenital heart disease, or infecting organisms. One-year mortality was significantly lower in the modern cohort (4%) compared with the historical cohort (38%) (PϽ.001). Conclusion: Most pediatric episodes of IE occur in patients with congenital heart disease. Mortality due to endocarditis has decreased in the modern era.

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Section: Echocardiographysupporting

confidence: 65%

Section: Echocardiographymentioning

confidence: 95%

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Infective Endocarditis in the Pediatric Patient: A 60-Year Single-Institution Review

Johnson

Boyce

Cetta

et al. 2012

Mayo Clinic Proceedings

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“…4,7 But this is in contrast to the western studies where majority of patients had presented beyond the fourth decade. 9,10 This can be due to the fact that RHD continues to be a significant problem in developing world which usually presents at younger age.…”

Section: Discussionmentioning

confidence: 99%

“…Increasing age of patients of IE in west is attributable to; markedly decrease frequency of RHD, 12 longer survival of patients with valve disease and CHD because of readily available modern medical and surgical therapy, increased incidence of degenerative valvular disease, 2 aging of the population in general 9,13 and more frequent use of invasive central vascular catheters which are associated with an increase in nosocomiallyacquired endocarditis. There was a significant rise in the age of the patients during the 1940s ,1950s and 1960s 14 and studies covering the time periods 1968-1973, 15 1973-1984 16 and 1970-1977 17 found the mean age to lie within the sixth decade.…”

Section: Discussionmentioning

confidence: 99%

Clinicomicrobiological profile of infective endocarditis in a tertiary care center of Nepal

Ghimire

Karki

Khanal

et al. 2013

J Coll Med Sci-Nepal

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BackgroundInfective endocarditis is a common problem and data regarding its clinical and microbiological pattern from developing countries are sparse. We studied clinical features and the microbiological pathogens in patients with Infective Endocarditis in our Hospital. ObjectiveTo study the clinical profile and microbiological pathogens involved in patients with Infective Endocarditis, admitted under Department of Internal Medicine of B.P Koirala Institute of Health Sciences. Materials and methodsA total of 54 patients with history of fever and underlying heart disease were studied. It was a hospital based cross sectional descriptive study done in patients with infective endocarditis presented to us from March 2007 to February 2008 in B.P Koirala Institute of Health Sciences. ResultsOut of 54 patients, 11 (20.4%) had Dukes definite IE. The male: female ratio was 1.2:1. The mean age of the study group was 27.3 years (range=16-55). In IE group, fever was present in 100% cases (n=11) as it was the inclusion criteria of the study, followed by SOB 81.8% (n=9). History of antibiotic therapy prior to the presentation was present in 36.7 % (n=4) patients. Pallor was the most common sign 63.6% (n=7). Splenomegaly was seen in 18.2% (n=2). Anaemia (Hb<10gm %) in 36.4% (n=4) and microscopic haematuria in 72.3% (n=8) cases. Blood culture positivity was seen in 36.4 %. The most common pathogens were Staphylococcus aureus in 27.3% (n=3) and Acinetobacter species in 9.1% (n=1).

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Prevention of Bacterial Endocarditis

Dajani¹

1990

JAMA

408

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The changing pattern of infective endocarditis in childhood

Cited by 123 publications

References 19 publications

Infective Endocarditis in the Pediatric Patient: A 60-Year Single-Institution Review

Infective Endocarditis in the Pediatric Patient: A 60-Year Single-Institution Review

Clinicomicrobiological profile of infective endocarditis in a tertiary care center of Nepal

Prevention of Bacterial Endocarditis

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