Lertsapcharoen Pornthep, Khongphatthanayothin Apichai, Chotivittayatarakorn Pairoj, Thisyakorn Chule, Pathmanand Chotima, Sueblinvong Viroj
Department of Pediatrics, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand.
J Med Assoc Thai. 2005 Sep;88 Suppl 4:S12-6.
To review the clinical features and outcome of the pediatric patients diagnosed with infective endocarditis (IE) at King Chulalongkorn Memorial Hospital over an 18-year period.
From January 1987 to December 2004, 57 pediatric patients; 28 females and 29 males, age ranged from 2 months to 15 years, mean of 8.64 +/- 3.82 years, classified as "definite" IE according to the Duke criteria were reviewed.
Of the 57 patients, 42 patients (74%) had underlying congenital heart diseases, 7 patients (12%) had underlying rheumatic heart disease, 8 patients (14%) had previously normal heart. Nine patients had history of previously palliative or corrective surgery. Blood cultures were positive in 26 patients (46%). Streptococci and staphylococci were the most commonly isolated organisms. Two-dimensional echocardiography demonstrated vegetations in 56 patients (98%). The location of the vegetations was in the right heart in 30 patients (54%) and in the left heart in 26 patients (46%). Complications occurred in 28 patients (49%). Common complications included congestive heart failure, cerebral emboli, septic shock, and mycotic aneurysm. The overall mortality was 11% (6 patients). By statistical analysis, vegetations in the left heart had a higher incidence of complication than that in the right heart. The vegetation size of > or =10 mm had a significant higher incidence of embolic events.
The clinical features and outcomes of the present study have a similar pattern as the earlier studies. The rates of complications and mortality are still high.
回顾朱拉隆功国王纪念医院18年间诊断为感染性心内膜炎（IE）的儿科患者的临床特征及预后。
对1987年1月至2004年12月期间57例儿科患者进行回顾性研究，其中女性28例，男性29例，年龄从2个月至15岁，平均年龄8.64±3.82岁，根据杜克标准分类为“确诊”IE。
57例患者中，42例（74%）有潜在先天性心脏病，7例（12%）有潜在风湿性心脏病，8例（14%）既往心脏正常。9例患者有既往姑息或矫正手术史。26例患者（46%）血培养阳性。链球菌和葡萄球菌是最常见的分离菌。二维超声心动图显示56例患者（98%）有赘生物。赘生物位于右心30例（54%），位于左心26例（46%）。28例患者（49%）发生并发症。常见并发症包括充血性心力衰竭、脑栓塞、感染性休克和霉菌性动脉瘤。总死亡率为11%（6例）。经统计学分析，左心赘生物并发症发生率高于右心。赘生物大小≥10 mm者栓塞事件发生率显著更高。
本研究的临床特征和预后与早期研究有相似模式。并发症和死亡率仍然很高。
