Infective endocarditis in Arkansan children from 1990 through 2002

Area of Science:

• Pediatric Cardiology
• Infectious Diseases
• Medical Informatics

Background:

• Medical and surgical advancements increase endocarditis risk in children.
• Epidemiology, pathogens, and outcomes of pediatric infective endocarditis (IE) may have changed.
• Understanding current trends in pediatric IE is crucial.

Purpose of the Study:

• To review the epidemiology, pathogens, and outcomes of infective endocarditis in pediatric patients.
• To identify changes in IE presentation and management over a decade.
• To assess the impact of risk factors and diagnostic methods on IE outcomes.

Main Methods:

• Retrospective review of medical records from Arkansas Children's Hospital (1990-2002).
• Inclusion criteria based on diagnostic standards for infective endocarditis.
• Data collected included demographics, clinical findings, echocardiogram results, and microbiology.

Main Results:

• 57 pediatric patients with IE were identified; congenital heart disease was the primary risk factor.
• Echocardiograms detected vegetations in 67%, with lower sensitivity in complex cyanotic heart disease.
• Streptococci and Staphylococcus aureus were common pathogens, with enterococci predominant in infants; complication rates decreased, but S. aureus remained linked to higher morbidity.

Conclusions:

• Infective endocarditis remains a significant pediatric challenge.
• Pathogen prevalence and outcomes have shown minimal change in the past decade.
• Reduced complication rates were observed, but S. aureus continues to be a concerning pathogen.