RESUMO
INTRODUCTION: IE is a rare infection in children. Scarce reports with large number of patients are published. METHODS: Between January 1988 to December 2000 we analyzed all cases of IE cases admitted to our hospital. RESULTS: 86 cases of IE (4.9/10,000 admissions) in 86 children were diagnosed. The median age was 7.6 years. In 77% of patient previous cardiac disease was detected, interventricular defects and Tetralogy of Fallot were the more frequent. Three percent of children had rheumatic heart disease. Thirty-six percent of children had previous heart surgery. Fifty-seven percent have been received previous antibiotics. Eighty-seven percent had positive blood cultures, being the S. aureus and S. viridans the predominantly. Forty-eight percent of children had complications. The metabolic disorders and the nosocomial infections were the most frequent. Twenty-four percent required surgery, 24% of them in the first week of the diagnosis. The mortality in operated children was 19%. In the multivariate analysis we could observe that children with more than 7 years and S. aureus isolation in blood cultures had more incidence of complications and posterior surgery (p < 0.05). Children with S. aureus IE had longer duration of fever, more incidence of complications than patients with S. viridans IE (p < 0.05). Ten percent of children were treated as outpatients. The global mortality was 12,8%. Previous surgery (OR = 6.89; IC 95% 1.54-30.7) and previous antibiotic treatment (OR = 9.98; IC 95% 1.12-88.8) were the factors related with higher mortality in the multivariate analysis. S. aureus was the predominat pathogen and caused more morbidity and mortality than S. viridans IE. CONCLUSION: Children with IE with previous surgery and previous antibiotic treatment died with more frequency.
Assuntos
Endocardite Bacteriana/mortalidade , Adolescente , Antibacterianos/uso terapêutico , Argentina/epidemiologia , Bacteriemia/complicações , Bacteriemia/epidemiologia , Criança , Pré-Escolar , Suscetibilidade a Doenças , Endocardite Bacteriana/diagnóstico por imagem , Endocardite Bacteriana/etiologia , Endocardite Bacteriana/cirurgia , Cardiopatias Congênitas/complicações , Cardiopatias Congênitas/epidemiologia , Humanos , Complicações Pós-Operatórias/mortalidade , Cardiopatia Reumática/complicações , Cardiopatia Reumática/epidemiologia , Fatores de Risco , Infecções Estafilocócicas/etiologia , Infecções Estafilocócicas/microbiologia , Infecções Estafilocócicas/mortalidade , Infecções Estafilocócicas/cirurgia , Staphylococcus aureus/isolamento & purificação , Staphylococcus aureus/patogenicidade , Infecções Estreptocócicas/etiologia , Infecções Estreptocócicas/microbiologia , Infecções Estreptocócicas/mortalidade , Infecções Estreptocócicas/cirurgia , Superinfecção , Ultrassonografia , Estreptococos Viridans/isolamento & purificação , Estreptococos Viridans/patogenicidade , VirulênciaRESUMO
Se discuten las diferentes manifestaciones renales (estructurales, funcionales e inmunológicas) de la Endocarditis Infecciosa asociadas a casos clínicos vividos.