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Infective endocarditis in children: profile in a developing country

A Dhawan1, A Grover, R K Marwaha

  • 1Department of Paediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Annals of Tropical Paediatrics
|January 1, 1993
PubMed
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Infective endocarditis in Indian children presents differently than in Western countries, often occurring in those with underlying heart conditions or preceding infections. This study highlights a high mortality rate in pediatric patients, emphasizing the need for tailored interventions.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Cardiology

Background:

  • Infective endocarditis (IE) is a serious infection affecting heart valves and inner lining.
  • Understanding the specific profile of IE in pediatric populations in developing countries is crucial for effective management.
  • Previous studies have primarily focused on IE in adults or in developed nations.

Purpose of the Study:

  • To investigate the clinical profile and outcomes of infective endocarditis in Indian children under 16 years of age.
  • To compare the characteristics of pediatric IE in India with those reported in Europe and the USA.
  • To identify risk factors and mortality predictors in this specific demographic.

Main Methods:

  • A retrospective study was conducted on 37 pediatric patients diagnosed with infective endocarditis between January 1984 and December 1990.

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  • Data collected included patient demographics, underlying cardiac conditions, preceding illnesses, microbiological findings, and treatment outcomes.
  • Statistical analysis was performed to determine the prevalence of different etiological agents and associated conditions.

    • Main Results:

    • The study included 37 patients (26 boys, 11 girls) aged 2-16 years.
    • A significant proportion had underlying heart disease: 48.6% congenital, 35.1% rheumatic.
    • Staphylococcus aureus and Streptococcus viridans were the most common pathogens identified; blood cultures were positive in only 43.2% of cases.
    • The mortality rate was high at 43.2%, attributed to hemodynamic compromise, sepsis, and limited surgical options.

    Conclusions:

    • Pediatric infective endocarditis in India exhibits a distinct profile compared to Western countries, with a notable prevalence of underlying heart disease.
    • The high mortality rate underscores the challenges in managing IE in developing nations, necessitating improved diagnostic and therapeutic strategies.
    • Early recognition and prompt intervention are critical for improving outcomes in children with infective endocarditis.