Borrelli Nunzia, Avesani Martina, Oreto Lilia, Leonardi Benedetta, Gaudieri Gabriella, Bianco Francesco, Bucciarelli Valentina, Sabatino Jolanda, Russo Maria Giovanna, Sarubbi Berardo, Di Salvo Giovanni
Adult Congenital Heart Disease Unit, Azienda Ospedaliera Dei Colli, Monaldi Hospital, Via Leonardo Bianchi, 80131, Naples, Italy.
University Hospital of Padua, 35127, Padua, Italy.
Pediatr Cardiol. 2025 Aug 14. doi: 10.1007/s00246-025-03984-5.
Infective endocarditis (IE) remains a significant cause of morbidity and mortality in pediatric patients with congenital heart disease (CHD), however, data on its epidemiology, risk factors, symptoms, complications, and outcomes remain scarce. This retrospective multicenter study analyzed pediatric patients (< 18 years) with CHD diagnosed with IE between 2008 and 2023. Clinical data-including demographic information, cardiac history, echocardiographic findings, microbiological results, treatment strategies, and outcomes-were collected and analyzed. A total of 41 patients were included. The most common risk factors were prior cardiac surgery or percutaneous intervention, prosthetic materials, and significant valvulopathies. A significant association was observed between vegetation size and embolic events, with larger vegetation conferring a higher embolic risk. Staphylococcus aureus and Coagulase-negative staphylococci were the most frequently isolated microorganisms. Fever, new onset or worsening valvulopathies, and vegetation or abscesses formation were the predominant clinical presentation. Aggressive medical and surgical management resulted in favorable outcome in most patients. While IE remains a major challenge in pediatric CHD patients, early detection and timely intervention are crucial for optimizing outcomes, particularly in patients with large vegetations. Future research should aim to identify additional risk factors and refine strategy for prevention and treatment in this high-risk population.
感染性心内膜炎（IE）仍然是先天性心脏病（CHD）儿科患者发病和死亡的重要原因，然而，关于其流行病学、危险因素、症状、并发症和结局的数据仍然匮乏。这项回顾性多中心研究分析了2008年至2023年间诊断为IE的CHD儿科患者（<18岁）。收集并分析了临床数据，包括人口统计学信息、心脏病史、超声心动图检查结果、微生物学结果、治疗策略和结局。共纳入41例患者。最常见的危险因素是既往心脏手术或经皮介入治疗、人工材料和严重瓣膜病变。观察到赘生物大小与栓塞事件之间存在显著关联，赘生物越大，栓塞风险越高。金黄色葡萄球菌和凝固酶阴性葡萄球菌是最常分离出的微生物。发热、新发或恶化的瓣膜病变以及赘生物或脓肿形成是主要临床表现。积极的内科和外科治疗使大多数患者获得了良好的结局。虽然IE仍然是儿科CHD患者面临的一项重大挑战，但早期发现和及时干预对于优化结局至关重要，尤其是对于有大赘生物的患者。未来的研究应旨在识别其他危险因素，并完善这一高危人群的预防和治疗策略。
