Behavior of infective endocarditis at the Pediatric Cardiocentro William Soler from 2000-2012

Abstract

Introduction: Infective endocarditis is a rare disease in children. There are few publications that include large numbers of patients and discuss their risk fact. Objective: To describe the clinical and epidemiological characteristics of pediatric infective endocarditis. Method: A retrospective descriptive study was performed in the 33 patients admitted for infective endocarditis (who met the Duke criteria) at the Pediatric Cardiocentro William Soler in Havana, Cuba, from January 2000 to July 2012. Medical records were reviewed to obtain the primary data. Variables were stored and analyzed with SPSS version 15.0. Absolute and relative frequencies were determined and for the association between qualitative variables the Chi Square Test of Independence was used. Results: Infective endocarditis predominated in female students (20/ 33 patients), the most frequent heart diseases were ventricular septal defect (50%) and tetralogy of Fallot (18.2%). Dental procedures (36.4% p < 0.01) and the use of intravascular catheters (36.4 % p < 0.05) were the most relevant risk factors. In 78.8 % of cases the presentation was subacute and in 57.6 %, nosocomial. Blood cultures were positive in 25 of 33 patients; in 14 of them (56 %) staphylococcal species were isolated. 46 complications were found, 30.4 % were congestive heart failure, followed by cerebral (21.8%) and lung embolisms, and pneumonia (10.9%). Conclusions: Infective endocarditis was more frequent in children with congenital heart disease, and was significantly associated with defined risk factors, had a subacute clinical presentation and germ acquisition was nosocomial. Most common isolated germs were staphylococcal species and regarding complications heart failure and heart embolisms predominated.