Key result
Among 21 children with infective endocarditis, 61.9% had congenital heart disease, 57.1% were blood culture-negative, and in-hospital mortality was 28.6%.
Why the study?
The epidemiology of pediatric infective endocarditis in India may be changing due to increased CHD corrective treatments, improved intensive care and antimicrobials, and declining rheumatic heart disease.
Observational (n=21)
No
Pediatric infective endocarditis in India increasingly affects younger children and those with structurally normal hearts, with a high rate of culture-negative cases suggesting a need to revise Duke criteria.
High mortality with frequent culture-negative pediatric endocarditis warrants diagnostic caution; leaves open whether Duke criteria require revision.
With an increasing number of children with congenital heart disease (CHD) undergoing corrective treatments, improved pediatric intensive care, better antimicrobial treatments, and a relative decrease in rheumatic heart disease over the years, the epidemiology of pediatric infective endocarditis in India may be undergoing a change. The study was done in the department of pediatrics of a tertiary care teaching hospital of North India. A retrospective analysis of case records of children (<12 years) admitted with a diagnosis of infective endocarditis (IE) from January 2013 to April 2019 was performed. Modified Duke's criteria were used to diagnose IE. There were 21 children diagnosed with infective endocarditis during this period. The mean age at presentation was 70 months (range: 2.5–144 months). CHD (n = 13/21, 61.9%) was the most common predisposing condition. A total of 28% (6/21) patients had no preexisting structural heart disease. Nine percent (2/21) had rheumatic heart disease. Staphylococcus aureus was the most common etiological agent in those with a structurally normal heart. Most patients had blood culture–negative infective endocarditis (n = 12, 57.1%). Only one patient fulfilled Duke's major microbiological criteria. Six patients (28.57%) died during the hospital stay. Increasingly younger children are being diagnosed with infective endocarditis in India and a significant number of them are in the setting of a structurally normal heart. In view of high percentage of culture-negative endocarditis, the Duke criteria may need to be revised to retain their sensitivity in such settings.
No takes yet. Share an insight, caveat, or question.
Kumar et al. (2021) conducted an observational in Pediatric infective endocarditis (n=21). Infective endocarditis was evaluated on In-hospital mortality. Among 21 children with infective endocarditis, 61.9% had congenital heart disease, 57.1% were blood culture-negative, and in-hospital mortality was 28.6%.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: