Infectious Endocarditis in Children: Epidemiological, Clinical, Paraclinical and Therapeutic Profile

Abstract

Introduction: Infective endocarditis (IE) in children is a serious pathology with high mortality and morbidity. The aim of our study was to describe the clinical, microbiological, therapeutic and evolutionary characteristics of infective endocarditis in children. Materials and methods: This is a retrospective study, listing all children aged less than 15 years, diagnosed in pediatric cardio consultation and hospitalized in the department of Pediatrics A-Mother and Child Hospital of Marrakech for infective endocarditis between 2010 and 2020. Clinical, paraclinical and therapeutic data were collected for each case using an exploitation form. Results: During the study period, 25 children presented with infective endocarditis, with a sex ratio equal to 1.08. The mean age of the patients was 9 years and 6 months. Underlying heart disease was found in 76% of cases. A cardiac murmur was noted in 96% of cases, and the most frequent germs were Staphylococcus and Streptococcus. Cardiac ultrasound revealed endocardial vegetations in 72% of the children. Intravenous antibiotic therapy was initiated in all children for a median of 45 days, and an indication for valve replacement was given in 16% of cases. According to the modified Duke criteria, 28% of the infective endocarditis cases were definite and the evolution was favorable in 80% of the children. The most frequent complications were valve failure, heart failure, and embolic complications, and death in 5 cases. Conclusion: The analytical study concluded that embolic complications, heart failure and neurological complications are predictive of mortality. Therefore, its management must be multidisciplinary, early and adequate.