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Infective endocarditis in South African children
Insights
Infective endocarditis in children is serious, especially in infants and those without heart conditions. Standardizing diagnostic criteria is crucial for better research and treatment of this pediatric cardiac infection.
Area of Science:
- Pediatric Cardiology
- Infectious Diseases
- Clinical Microbiology
Background:
- Infective endocarditis (IE) is a severe infection affecting heart valves, posing significant risks in pediatric populations.
- Understanding the epidemiology and risk factors in children is crucial for timely diagnosis and management.
Purpose of the Study:
- To retrospectively review clinical and laboratory findings of infective endocarditis in a pediatric cohort over a decade.
- To identify common causative organisms, associated cardiac conditions, and risk factors for mortality.
Main Methods:
- Retrospective chart review of 29 pediatric patients diagnosed with infective endocarditis.
- Analysis of patient demographics, cardiac history, surgical interventions, causative microorganisms, and outcomes.
Main Results:
- Congenital heart disease (70%) and prior cardiac surgery (41%) were common. Staphylococcus aureus, S. epidermidis, and viridans streptococci were frequent pathogens.
- A high case fatality rate (35%) was observed in children under 6 months. Patients without underlying cardiac abnormalities faced increased risk.
Conclusions:
- Infective endocarditis in children presents with diverse underlying conditions, with infants and those without prior cardiac issues being particularly vulnerable.
- Standardization of diagnostic criteria for pediatric infective endocarditis is needed to improve epidemiological studies and collaborative research.
Abstract:
The clinical and laboratory findings in 29 children with infective endocarditis over the past 10 years are reviewed retrospectively. Twenty children (70 per cent) had congenital heart disease, five (16 per cent) had rheumatic heart disease, and four (14 per cent) had no underlying cardiac abnormality prior to presentation. Twelve (41 per cent) patients had undergone cardiac surgery prior to developing endocarditis. The most common causative organisms were Staphylococcus aureus, Staphylococcus epidermidis, and viridans streptococci none of which was associated with a significantly greater mortality. There was a high case fatality rate of 35 per cent of children below the age of 6 months and children without an underlying cardiac abnormality were particularly at risk. There is a need for standardization of diagnostic criteria for infective endocarditis to facilitate accurate collaborative epidemiological investigation.