Parras F, Bouza E, Romero J, Buzón L, Quero M, Brito J, Vellibre D
Infectious Disease Unit, Hospital Ramón y Cajal, Madrid, Spain.
Pediatr Cardiol. 1990 Apr;11(2):77-81. doi: 10.1007/BF02239566.
With the object of analyzing current characteristics of infectious endocarditis (IE) in children, we carried out a retrospective study of 23 cases of IE in children under 15 years of age seen at the Hospital Ramón y Cajal in Madrid (Spain) between 1977 and 1985. The incidence was high (1.3 cases per 1000 children admitted). The male/female ratio was 2:1. Eight patients were under 2 years of age and 15 over 2 years, the majority being adolescents. The two groups presented marked etiological and prognostic differences. Congenital heart disease was the predisposing factor in 20 of the 23 cases. Streptococcus viridans (nine cases) and Staphylococcus aureus (eight cases) were the most frequent organisms. Fourteen cases were on a native valve and nine were secondary (seven of these on prosthetic patches). In spite of advances in therapy, IE continues to be a severe illness: the mortality rate in our series was 26%. Factors associated with a poor prognosis were: age less than 2 years, Staphylococcus aureus as the causative agent, and the presence of prosthetic material.
为分析儿童感染性心内膜炎（IE）的当前特征，我们对1977年至1985年间在西班牙马德里拉蒙·卡哈尔医院就诊的15岁以下23例儿童IE病例进行了回顾性研究。发病率较高（每1000名入院儿童中有1.3例）。男女比例为2:1。8例患者年龄在2岁以下，15例在2岁以上，大多数为青少年。两组在病因和预后方面存在明显差异。23例病例中有20例的易感因素为先天性心脏病。草绿色链球菌（9例）和金黄色葡萄球菌（8例）是最常见的病原体。14例为自然瓣膜感染，9例为人工瓣膜感染（其中7例感染发生在人工补片上）。尽管治疗取得了进展，但IE仍然是一种严重疾病：我们研究系列中的死亡率为26%。与预后不良相关的因素包括：年龄小于2岁、金黄色葡萄球菌作为病原体以及人工材料的存在。
