title: Infective endocarditis in pediatric patients: an eighteen-year experience from King Chulalongkorn Memorial Hospital.
abstract: OBJECTIVE
  To review the clinical features and outcome of the pediatric patients diagnosed with infective endocarditis (IE) at King Chulalongkorn Memorial Hospital over an 18-year period.
  
  
  METHODS
  From January 1987 to December 2004, 57 pediatric patients; 28 females and 29 males, age ranged from 2 months to 15 years, mean of 8.64 +/- 3.82 years, classified as "definite" IE according to the Duke criteria were reviewed.
  
  
  RESULTS
  Of the 57 patients, 42 patients (74%) had underlying congenital heart diseases, 7 patients (12%) had underlying rheumatic heart disease, 8 patients (14%) had previously normal heart. Nine patients had history of previously palliative or corrective surgery. Blood cultures were positive in 26 patients (46%). Streptococci and staphylococci were the most commonly isolated organisms. Two-dimensional echocardiography demonstrated vegetations in 56 patients (98%). The location of the vegetations was in the right heart in 30 patients (54%) and in the left heart in 26 patients (46%). Complications occurred in 28 patients (49%). Common complications included congestive heart failure, cerebral emboli, septic shock, and mycotic aneurysm. The overall mortality was 11% (6 patients). By statistical analysis, vegetations in the left heart had a higher incidence of complication than that in the right heart. The vegetation size of > or =10 mm had a significant higher incidence of embolic events.
  
  
  CONCLUSIONS
  The clinical features and outcomes of the present study have a similar pattern as the earlier studies. The rates of complications and mortality are still high.
authors.affiliation: Department of Pediatrics, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand.
authors.forename: Pornthep
authors.initials: P
authors.lastname: Lertsapcharoen
authors.forename: Apichai
authors.initials: A
authors.lastname: Khongphatthanayothin
authors.forename: Pairoj
authors.initials: P
authors.lastname: Chotivittayatarakorn
authors.forename: Chule
authors.initials: C
authors.lastname: Thisyakorn
authors.forename: Chotima
authors.initials: C
authors.lastname: Pathmanand
authors.forename: Viroj
authors.initials: V
authors.lastname: Sueblinvong
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004621:Embolization, Therapeutic; D004697:Endocarditis, Bacterial / Q000150:complications / Q000175:diagnosis* / Q000382:microbiology; D005260:Female; D006330:Heart Defects, Congenital / Q000150:complications; D006333:Heart Failure / Q000209:etiology; D006760:Hospitalization / Q000706:statistics & numerical data; D006786:Hospitals, Urban / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D008297:Male; D008485:Medical Audit; D017063:Outcome Assessment, Health Care; D012189:Retrospective Studies; D012307:Risk Factors; D013211:Staphylococcus aureus / Q000302:isolation & purification; D013291:Streptococcus / Q000302:isolation & purification; D013785:Thailand; D013997:Time Factors