Infective Endocarditis n Children admitted to Kenyatta National Hospital - a retrospective study
Abstract
This is a retrospective study, presenting the clinical
and aetiologic features of infective endocarditis, in 45
children aged 0-15 years, seen over a six year period
(January 1975 to December 1980), at the Kenyatta National
Hospital.
The illness had been present for two ,weeks or less
in 56% of the children. The majority presented with
symptoms due to cardiac disease, and less commonly due to
extracardiac problems. The most frequent clinical features
were cardiac failure (88%), pyrexia (77/%) splenomegaly
(52%), renal manifestations (40%), and finger clubbing ,
(33%), the other features occurred in less than 15% of
cases. Anaemia (38%), leucocytosis (42~';), and elevated
ESR (52%) were also common.
Rheumatic heart disease was the underlying hear-t
problem in 82%, congenitaI heart disease in 14% combined
rheumatic and congenital heart disease in 2%, and no
pre-existing heart disease in 2%.
The blood cultures were positive in 31/~ of cases.
The isolated organisms were species of either staphylococci,
enterobacterincene or a mixed culture.
It is concluded that infective endocarditis is
common with a high mortality rate (42%). Organic
heart disease is almost aIways present. The "classic"
picture of the disease is rare. The positive blood
culture rates are low. It is recommended that more
laboratory diagnostic aid be utilised to support the
diagnosis.
Citation
Masters of Medicine (Paediatrics)Publisher
University of Nairobi School of Medicine