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CC BY 4.0 · Journal of Child Science 2021; 11(01): e250-e254
DOI: 10.1055/s-0041-1735881
Original Article

Contemporary Pattern of Pediatric Infective Endocarditis from Tertiary Care Centre of Northern India: A Single Centre Experience

Dinesh Kumar
1   Department of Paediatric Cardiology, Division of Paediatric Cardiology, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, New Delhi, India
,
Shikha Garg
1   Department of Paediatric Cardiology, Division of Paediatric Cardiology, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, New Delhi, India
,
Dheeraj D. Bhatt
1   Department of Paediatric Cardiology, Division of Paediatric Cardiology, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, New Delhi, India
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Funding None.
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Abstract

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.

Keywords

infective endocarditis - pediatrics - duke criteria - blood culture–negative infective endocarditis

Ethical Approval

Approval of the institutional ethical committee was obtained for this study.




Publikationsverlauf

Eingereicht: 06. April 2021

Angenommen: 06. August 2021

Artikel online veröffentlicht:
21. September 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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