CHANGES OF CLINICAL
MANIFESTATIONS IN CHILDREN WITH INFECTIVE ENDOCARDITIS
Chen Y, Tian J, Yu
GS and Qian YR
Children’s Hospital,
Chongqing Medical University, Chongqing, China
Objective: To study clinical changes of
children with infective endocarditis (IE).
Methods: 34 cases of IE diagnosed in our
hospital from 1964 to 1983 (group A) were compared with 38 cases of IE from
1984 to 1999 (group B). The clinical investigations included underlying
disease, clinical manifestation, blood culture, ultrasound cardiogram et
al.
Results: Congenital heart disease
accounted for 56% of 72 cases IE and acquired heart disease for 22%. 13% of
IE with rheumatic heart disease as underlying diseases in group B was lower
than 27% of group A. 29% of IE without structural heart disease seen in group
B that was higher than 15% of group A. Clinical manifestations of petechia
or ecchymosis, splenomegaly and arterial embolism decreased while heart
failure markedly increased. The incidence of staphylococcus aureus as causative
pathogen showed 14% in group B that decreased in comparison with 55% of
group A and opportunistic pathogens including tetrads, saprophytic or epidermal
staphylococcus and klebsiella were isolated in 64% positive cultures
of group B that significantly increased in comparison with 0% of group A.
Conclusion: Congenital heart disease is
still predominant underlying diseases for IE. In recent 16 years, there is
a marked decline in the frequency of IE among patients with rheumatic heart
disease and a rising frequency of IE without structural heart disease,
staphylococcus aureus as causative pathogen is decreasing and opportunistic
pathogen is increasing.