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HK J Paediatr (New Series)
Vol 19. No. 4,
2014
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HK J Paediatr (New Series) 2014;19:225-232
Original Article
Twelve Years of Experience in the Treatment of Paediatric Infective Endocarditis
XY Xu, MR Huang, SB Chen, Y Guo, LJ Fu, PJ Zhao, W Gao, F Li, Y Li, ZQ Yu Department of Pediatric Cardiology, Shanghai Children's Medical Center, Medical Institute, Shanghai Jiao Tong University, 1678 Dongfang Road, Shanghai (200127), China XY Xu (徐忻怡) MD MR Huang (黃美容) MD SB Chen (陳樹寶) MD Y Guo (郭瑩) MD LJ Fu (付立軍) MD PJ Zhao (趙鵬軍) MD W Gao (高偉) MD F Li (李奮) MD Y Li (李筠) MD ZQ Yu (余志慶) MD Correspondence to: Dr MR Huang Received November 18, 2013
Abstract Objective: The aim of this study was to review our 12 years of experience with the diagnosis and treatment of paediatric infective endocarditis (IE). Methods: Patients hospitalised between March 1999 and December 2011 were enrolled, and clinical data were retrospectively analysed. Results: Of the total 93 patients, 83 had underlying diseases and/or predisposing factors. Pathogenic microorganisms were detected on blood culture in 61 patients (65.6%). The positive rates of patients hospitalised between 1999 and 2007, and between 2008 and 2011, were 49.1% and 89.5%, respectively. Intracardiac vegetations were found in 82 patients. A total of 16 patients experienced embolisms, and 3 patients experienced intracranial bleeding. Heart failure occurred in 24 patients. Acute renal insufficiency occurred in 6 patients. Aortic pseudoaneurysm occurred in 2 patients. The duration of antibiotics ranged from 28 to 130 days. Surgery was performed in 58 patients after a mean of 21.88±12.4 days of antibiotic therapy. The mortalities were 44% and 3.4%, respectively, in the patients who received antibiotic therapy only and received both antibiotic and surgical therapy. Conclusions: The congenital heart defects and postoperative residual anatomical abnormalities are important factors that leave children susceptible to IE. The patients colonised with Staphylococcus aureus showed a tendency for embolism formation and death. Keyword : Congenital heart defects; Infective endocarditis; Paediatrics; Pathogenic bacteria culture Abstract in Chinese
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