Twelve Years of Experience in the Treatment of Paediatric Infective Endocarditis

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.