Infective endocarditis in children-pattern, diagnosis, management and short term outcome in Sudan

Abstract

Introduction: Infective Endocarditis (IE) in children is relatively rare but causes significant morbidity and mortality when it occurs. The incidence of IE in children is increasing worldwide. Objective: To identify pattern, management and short outcome of IE in Sudanese children. Methods: Retrospective notes review of all the children from birth to 16 years old, diagnosed with IE at Ahmed Gasim Children’s hospital, Khartoum North, Sudan. During the 12 month period starting from January 2017. All children who fulfilled Dukes criteria for Definite or Possible IE were included in the study. Results: During the study period 6260 children were admitted to Ahmed Gasim Children’s hospital, 47 patients fulfilled Dukes criteria for IE; Three patients were labelled as Definite and 44 as Possible, The majority of the patients were overfive years old. Of the 47 patients enrolled in the study,34% had normal hearts and 66.0% were known to have structural cardiac disease; out of them, 17 patients (54.8%) were known to have Rheumatic heart disease (RHD) and 14 patients (45.2%) were known to have Congenital Heart Disease (CHD).The hospital mortality was 21.3%. Conclusion and Recommendation: IE in Sudanese children is not rare and is associated with high hospital mortality,the health professionals should have a high index of suspicion to diagnose IE echocardiography and blood culture should be done whenever the possibility of endocarditis is entertained. The children, parents and caregivers of children with structural heart disease should be educated about IE’spresentation and prevention.