All issues > Volume 32(1); 1989

Original Article

J Korean Pediatr Soc. 1989;32(1):11-19. Published online January 31, 1989.

A Clinical Observation on Infective Endocarditis in Childhood.

Kyung Ae Yoon¹, Hoan Jong Lee¹, Young Yull Koh¹, Jung Yun Choi¹, Yong Soo Yun¹, Chang Yee Hong¹

¹Department of Pediatrics, College of Medicine, Seoul National University， Seoul, Korea

Received: May 11, 1988;  Accepted: August 16, 1988.

Abstract

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%).

Keywords :Infective Endocarditis