Infective endocarditis in children in the Guinea savannah of Nigeria.
Thirty-two children with 33 episodes of infective endocarditis were admitted into the paediatric unit of Ahmadu Bello University Teaching Hospital, Zaria during an 8-year period (January 1982-December 1989). Thirty (94%) had underlying heart disease. Rheumatic heart disease was the pre-existing anomaly in 21 (66%) while congenital cardiac anomalies were detected in nine (28%). Cardiac failure, changing murmur or persisting fever drew attention to the disease. Bacterial isolation was achieved in 19 patients (58%), staphylococci in 11, and salmonella was found in three children. Others included Acinetobacter spp. in two patients, one of whom had a mixed infection involving alpha haemolytic streptococcus whereas three children had Klebsiella, pseudomonas or alpha haemolytic Streptococcus, respectively. Only six patients (18%) recovered. Abscondment rates were high (28%) and overall hospital mortality was 47%. Intractable cardiac failure and neurological complications were the most important events heralding death. There is a need for increased awareness and improved facilities for prompt and effective treatment.
Ifere
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Department of Paediatrics, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria.
Masokano
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D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004697:Endocarditis, Bacterial / Q000453:epidemiology* / Q000209:etiology / Q000382:microbiology; D005260:Female; D006330:Heart Defects, Congenital / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D007223:Infant; D008297:Male; D009549:Nigeria / Q000453:epidemiology; D012189:Retrospective Studies; D012214:Rheumatic Heart Disease / Q000150:complications* / Q000453:epidemiology; D016019:Survival Analysis