[Clinico-morphological comparison in children with infectious endocarditis]

Area of Science:

• Pediatric Cardiology
• Infectious Diseases
• Pathology

Background:

• Infectious endocarditis (IE) is a serious heart infection.
• Pediatric IE cases present unique clinical and morphological challenges.
• Understanding IE's impact on young patients is crucial for timely intervention.

Purpose of the Study:

• To analyze the clinical and morphological features of infectious endocarditis in children.
• To identify diagnostic difficulties and their impact on treatment initiation.
• To investigate associated cardiac pathologies and causes of mortality in pediatric IE.

Main Methods:

• Retrospective analysis of 21 pediatric patients with infectious endocarditis.
• Examination of clinical data, including age, underlying conditions, and diagnosis.
• Morphological examination of cardiac tissues from autopsy (19 cases) and surgical (2 cases) specimens.

Main Results:

• IE was diagnosed in children aged 2-15 years, often associated with congenital heart disease (15/21).
• Early diagnosis of IE proved difficult, leading to delayed antibacterial therapy.
• Focal myocarditis and postmyocarditic cardiosclerosis were common, contributing to refractory heart failure.

Conclusions:

• Difficulties in early IE diagnosis in children can delay critical antibacterial treatment.
• Associated myocarditis and cardiosclerosis contribute significantly to heart failure in pediatric IE.
• Heart failure and thromboembolism remain the primary causes of mortality in children with IE.