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Cardiac findings in childhood staphylococcal sepsis
Hüseyîn Caksen1, Kazim Uzüm, Saban Yüksel
1Department of Pediatrics, Faculty of Medicine, Yüzüncü Yil University, Van, Turkey.
Insights
Cardiac involvement, including pericardial effusion, is common in childhood Staphylococcus aureus sepsis. Prompt monitoring and supportive care are crucial for better outcomes in these pediatric patients.
Area of Science:
- Pediatrics
- Infectious Diseases
- Cardiology
Background:
- Sepsis caused by Staphylococcus aureus (S. aureus) can lead to severe complications.
- Cardiac involvement is a significant concern in pediatric sepsis, impacting patient prognosis.
Purpose of the Study:
- To highlight the prevalence and clinical significance of cardiac findings in children with S. aureus sepsis.
- To emphasize the need for vigilant cardiac monitoring in pediatric S. aureus sepsis cases.
Main Methods:
- Retrospective review of clinical and laboratory data from 39 pediatric patients with S. aureus sepsis.
- Analysis of cardiac involvement, including echocardiographic findings, in 8 identified cases (20% of the cohort).
Main Results:
- All 8 patients exhibited pericardial effusion, confirmed by echocardiography (ECHO) in most cases.
- One patient developed myocarditis and heart failure, while another had mitral insufficiency. Cardiac tamponade occurred in one case requiring drainage.
- The mortality rate among the 8 patients with cardiac involvement was 25% (2 deaths) due to sepsis and septic shock.
Conclusions:
- Cardiac involvement, particularly pericardial effusion, is a frequent complication of S. aureus sepsis in children.
- Early detection and management of cardiac complications are essential for improving survival rates in pediatric S. aureus sepsis.
Abstract:
The clinical and laboratory findings of eight (20%) cases of cardiac involvement of 39 patients with sepsis caused by S. aureus (Staphylococcus aureus) were reviewed retrospectively. Our purpose was to emphasize the importance of the cardiac findings in patients with sepsis caused by S. aureus in childhood. The ages of the patients ranged from 6 to 14 years. All patients had pericardial effusion which was confirmed by echocardiographic (ECHO) examination in all cases except the one in whom ECHO examination could not be performed because he died 2.5 days after admission to the hospital. This patient also had myocarditis and heart failure. Aside from these, mitral insufficiency was diagnosed in the other patient; it was accepted as a sequela of rheumatic fever acquired previously. Open pericardial drainage was conducted successfully in the case who had a progression to cardiac tamponade. In the other patients pericardial effusion completely resolved with supportive and antibiotic therapy one to two weeks. Two of eight patients died from sepsis and septic shock; the mortality rate was 25%. Our findings show that cardiac involvement was fairly high (20%) in S. aureus sepsis in childhood. Therefore, it is suggested that children with S. aureus sepsis should be carefully monitored for cardiac involvement.