engleski

Pediatric infective endocarditis: case series

Background Congenital heart disease (CHD) is the predominant underlying condition for infective endocarditis (IE) in children. Increasingly, IE develops in the absence of CHD, mostly in patients with indwelling catheters. In 8 to 10% of all cases there is no identifiable risk factor. Case Presentation Summary A total of 9 cases of IE in subjects <18 years of age were treated in University Hospital for Infectious Diseases in Zagreb in the past 13 years (2005-2017). There were 5 boys and 4 girls, aged 7 months to 17 years (median 7 years). 55% of cases were caused by common pathogenic bacteria (2 Coagulase-negative Staphylococcus, 2 Staphylococcus aureus, 1 Streptococcus sanguinis), while almost half of them (45%) were caused by relatively uncommon organisms in pediatric population: Enterococcus faecalis, Granulicatella adiacens, Haemophilus parainfluenzae and Abiotrophia defectiva (1 patient each). Although one (11%) patient didn´t have risk factor for IE, all of the others had CHD and one of them had central venous catheter as well. One patient (with IE due to S. aureus) had septic embolisation (meningoencephalitis) and two patients had relapse of IE (caused by KNS and Staphylococcus aureus). The most frequent antibiotic regimen for first 2 weeks of therapy was penicillin or its derivatives combined with gentamicin. Total duration of treatment was 6-8 weeks. Mortality rate was 22%, while others recovered completely. Learning Points/Discussion IE is a rare bacterial infection usually affecting children with CHD. Although IE is uncommon in children without risk factors, it should be suspected in patients with nonspecific clinical symptoms. In our case series Staphylococcus spp predominated as causative microorganism. We also noticed high proportion of cases caused by unusual bacteria and relatively low prevalence of streptococcal IE.

infective endocarditis ; congenital heart disease ; Staphylococcus spp

nije evidentirano