Abstract Ref Number = APCP779
Case series of various predisposing cardiac and non-cardiac disease in native valve endocarditis
Eko Kristanto KuntaAdjie,Ni Putu Veny Kartika Yantie,Eka Gunawijaya
Departement of Childs Health Departement of Childs Health, Medical Faculty Udayana University, Sanglah Hospital
Background : Infective endocarditis (IE) is life threatening infection of inner surface of endocardial caused by bacterial, fungal and viral. Predisposition of IE can be multi any possibilities, mostly with congenital heart defect (cyanotic and acyanotic) or dental infection and surgical procedure. We aimed to asses the clinical features of infective endocarditis in our institution.
Case Presentation Summary : From 2016 to May 2018 there was 7 cases (3 male, 4 female) aged range 6 year-old to 17 year-old. Underlying heart disease was seen mostly which were rheumatic heart disease (3 patients, and 1 with comorbidity malignancy on chemotherapy), tetralogy of Fallot (2 patients), patent ductus arterious (1 patient), and only 1 case with HIV infection. The portal of entry mostly was unknown, however most patients has poor oral hygiene and 2 patients immunocompromised state. Left heart valve were most often affected assessed by transthoracic echocardiography. Duke criteria was identified, 5 patients with possible IE (vegetation but negative culture) and 2 patients with definite IE (vegetation and positive culture). Staphylococcus aureus and Streptococcus gordoni were isolated pathogen in positive culture patients which sensitive to ampicillin, ceftriaxone, and cefazolin. Early mortality was found in 2 patients, unfortunately they shown a vascular and or immunological phenomena and vegetation size of more than 10 mm.
Learning Points/Discussion : Predisposing heart condition and poor oral hygiene were at risk of IE. Negative blood culture and left side IE were common. Vascular and or immunological phenomena, vegetation size of more than 10 mm may be used to estimate mortality in infective endocarditis.
Keywords: Infective Endocarditis Predisposing Factors Pediatric