Original articleInfective Endocarditis in the Pediatric Patient: A 60-Year Single-Institution Review
Section snippets
Patients and Methods
In this institutional review board–approved study, we searched the Mayo Clinic Division of Infectious Diseases endocarditis database for any patient younger than 20 years diagnosed with IE between January 1,1980, and June 30, 2011. We reviewed all potential cases to confirm that they met the modified Duke criteria for the diagnosis of IE.7 Extracted variables included patient demographic characteristics, infecting organism, history of CHD, prior cardiac surgery, morbidity, mortality, previous
Statistical Analyses
Data were analyzed using JMP 7.0 statistical software (SAS Institute Inc, Cary, NC). All continuous variables were reported as mean ± SD. Proportions were analyzed and compared using the Fisher exact test. Means were analyzed using the independent group t test for means. A 2-sided P value of less than .05 was considered statistically significant.
Demographic Characteristics and Cardiac History
During the 60-year study period (1950-2011) encompassing the 2 cohorts, 97 pediatric patients with IE were seen at our institution. These 97 patients were diagnosed with a total of 103 unique cases of IE. Patient demographic characteristics for both cohorts are shown in Table 1. There were no statistically significant differences for gender, age, and history of CHD. The most common time of presentation in both cohorts was in the teenage years. In cohort 1, 20 of 50 diagnosed episodes IE (40%)
Discussion
Infective endocarditis is rare in the pediatric population but can cause significant morbidity and mortality, particularly in patients with CHD. We report a comprehensive review of IE cases seen at our institution during a 60-year period.
Conclusion
Infective endocarditis continues to be rare in the pediatric population, and most cases now occur in patients with complex CHD rather than the isolated VSD that predominated earlier cohorts. Mortality related to endocarditis is significantly lower in the modern era. The most commonly diagnosed pathogens in pediatric IE have remained consistent throughout the 60 years of our study. Unusual pathogens are now more common in patients with CHD. Modern echocardiographic techniques facilitate the
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