Resumen

IGLESIAS, María Soledad et al. Características clínicas y evolutivas de niños con endocarditis infecciosa hospitalizados en dos centros asistenciales de referencia: Uruguay 2000 - 2010. Rev. Méd. Urug. [online]. 2013, vol.29, n.4, pp.219-225. ISSN 1688-0390.

Abstract Introduction: infective endocarditis (IE) is rather unusual in children, being morbimortality rates high. Variations determining modifications in the therapeutic approach have been described in terms of their epidemiology and etiology. Objective: to describe the clinical characteristics and evolution of children with IE in two reference centers in Uruguay: Pereira Rossell Hospital Center (CHPR) and Child Cardiology Institute (ICI), from 2000 through 2010. Method: observational, descriptive, retrospective study. Risk factors were analysed along with clinical characteristics, etiology, echocardiographic and necropsy findings, and complications in children between 0 and 14 years old with IE. Duke criteria were used to define cases. Results: 25 children were identified, 15 boys, average age was 48.2 months. Sixteen children evidence structural heart disease: congenital heart disease (15), and rheumatic heart disease (1). Ten of the children with congenital heart disease had undergone cardiac surgery or invasive vascular procedures. Bacterial etiology was confirmed in 23 cases, being Staphylococcus aureus isolated in 9. Twenty children evidenced valve vegetations and 17 children underwent surgery. Five of them suffered embolic complications. Five children died. Necropsy was performed in one patient. Conclusion: timely blood cultures enabled the identification of the etiological agent in most cases. Staphylococcus was the most frequent etiology and thus, empirical antibiotic therapy needs to consider this finding. The high rate of IE in children without heart disease is pointed out. In this series, serious complications were observed, requiring surgery. Mortality was 20%.

Palabras clave : ENDOCARDITIS BACTERIAL; CLINICAL EVOLUTION.

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