| A Clinical Observation on Infective Endocarditis in Childhood. |
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Kyung Ae Yoon, Hoan Jong Lee, Young Yull Koh, Jung Yun Choi, Yong Soo Yun, Chang Yee Hong |
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Department of Pediatrics, College of Medicine, Seoul National University， Seoul, Korea |
| 소아의 감염성 심내막염에 관한
임상적고찰 |
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윤경애, 이환종, 고영률, 최정연, 윤용수, 홍창의 |
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서울대학교 의과대학 소아과학교실 |
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Received: 11 May 1988 • Accepted: 16 August 1988 |
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| Abstract |
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Fifty.Six cases with infective endocarditis who were admitted to Department of Pediatrics, Seoul
National University Hospital from January 1979 to December 1986 were reviewed.
All the cases were confirmed bγ clinical findings, blood culture and echocardiographic findings.
The incidence of infective endocarditis was 0.25/ 1,000 admissions. Male to female ratio was 1.2:1. All
the cases had heart defect that was congenital heart disease in 48 (86%) and rheumatic heart disease
in 8 (14%). Two cases developed infective endocarditis after surgical repair of heart defect, 1 case of
congenital heart disease and 1 case of rheumatic heart disease each. Blood culture was positive in 30
cases (54%). In culture positive group, streptococcus was most commonly isolated and was sensitive
to penicillin, methicillin and cephalosporin. Staphylococcus and Streptococcus epidermidis were next
common orgamsms.
Frequent symptoms at admission were fever (90%), dyspnea (20%), chest pain (5%) and malaise (4
%), physical findings showed hepatomegaly (48%), splenomegaly (14%) and petechiae (7%), Labora-
tory findings were anemia (68%), elevation of erythrocyte sedimentation rate (59%), leukocytosis (63
%), hematuria (32%), perfusion defect in lung scan (18%) and elevated transaminase (13%).
Complications developed in 41 cases (73%). They were renal complication (32%), pulmonary
embolism (29%), intractable congestive heart (21 %) and central nervous system lesion (7%). Overall
mortality rate was 18%. There was no significant difference in mortality between culture positive (13
%) and culture negative group (23%). |
| Key Words:
Infective Endocarditis |
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