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Infective endocarditis in children and adolescents: a different profile with clinical implications

Lourdes Vicent1, Miguel Angel Goenaga2, Patricia Muñoz3

  • 1Servicio de Cardiología, Hospital Universitario Doce de Octubre, Instituto de Salud Carlos III, Madrid, Spain.

Pediatric Research
|February 12, 2022
PubMed

Insights

Pediatric infective endocarditis (IE) differs from adult cases, particularly in patients with congenital heart disease (CHD). IE in children without CHD mirrors adult profiles, with less heart failure but similar mortality rates.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Pediatrics

Background:

  • Infective endocarditis (IE) is a serious infection affecting heart valves and inner lining.
  • Understanding pediatric IE is crucial, as it may present differently than in adults.
  • Congenital heart disease (CHD) is a significant factor in pediatric IE cases.

Purpose of the Study:

  • To compare the clinical profile and outcomes of pediatric infective endocarditis (IE) with that of adult IE.
  • To identify specific characteristics of IE in children and adolescents, particularly in relation to CHD.

Main Methods:

  • A prospective, multicenter registry study was conducted across 31 Spanish hospitals.
  • Data were collected from 5590 patients diagnosed with IE between 2008 and 2020.
  • Patients were categorized into pediatric (<18 years) and adult groups for comparative analysis.

Main Results:

  • Pediatric IE (0.1% of cases) was frequently associated with CHD (63.2%), showing a higher prevalence of right-sided IE (46.9%) and pulmonary IE (48.4%).
  • Staphylococcus aureus was a more common etiology in pediatric patients (32.7%) compared to adults (22.3%).
  • Heart failure was less common in pediatric patients with CHD (9.6%) than in those without (44.4%), though in-hospital mortality was high in both groups (16.3% vs. 25.9%).

Conclusions:

  • Pediatric IE is predominantly seen in patients with CHD, characterized by right-sided location and lower heart failure rates compared to non-CHD patients.
  • IE in children and adolescents without CHD exhibits a clinical profile more similar to adult IE, including left-sided predominance and acute heart failure as a frequent complication.
  • Despite differences in presentation, in-hospital mortality remains a significant concern across all age groups and CHD statuses.
Abstract

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