MEDICAL EDUCATION CENTER, NOSRAT AVE, TOHID SQ., TEHRAN, IRAN
Abstract
Background- The role of transthoracic echocardiography and the sensitivity rate of blood culture in the early diagnosis of infective endocarditis (IE) are not defined accurately in Iranian childhood population. Methods- Thirty-six episodes of IE were evaluated in 36 children admitted to hospitals affiliated with Tehran University of Medical Sciences during a 5-year period (1996- 2000). The patients' major complaints, clinical findings, the medication they had been receiving and their tests and echocardiographic data were studied. Results- The average age was 10.38±3.348 years. Overall, the male/female ratio was 2:1; fever was the most common complaint (100%). Sixty-six percent of the patients had fever more than 7 days. Congenital heart disease was the most common underlying disease (66%), followed by rheumatic heart disease (RHD, 22%). Congestive heart failure (CHF) was present in 30.5% of the cases. Blood cultures were positive in 42%, and vegetations were seen in 83.4% by 2-dimensional echocardiography (echo). Blood culture and echo sensitivity and specificity were 45 vs. 90.5 (p<0.00l) and 60 vs. 75 (p<0.05), respectively. The most common site of vegetation was the aortic valve area, followed by the tricuspid valve. Staphylococus aureus was the most common infecting microorganism. There were 6 deaths (16.6%) due to different causes. Indicators for mortality include negative cultures, infection with S. aureus, large vegetation and CHF. All mortalities had left-sided vegetations (p<0.05). Conclusions- In contrast to the high sensitivity of blood cultures in IE in developed countries, in the developing countries the result of blood culture is not reliable. Therefore, echocardiography can play a major role in the early diagnosis of IE and can change the outcome of this potentially serious illness.
ZEAINLOU, A., MIRKHANI, H., NIAZI, M. (2004). THE ROLE OF TRANSTHORACIC ECHOCARDIOGRAPHY IN THE EARLY DIAGNOSIS OF INFECTIVE ENDOCARDITIS IN PEDIATRICS. Iranian Heart Journal, 5(3), 16-22.
MLA
ALI AKBAR ZEAINLOU; H. MIRKHANI; M. NIAZI. "THE ROLE OF TRANSTHORACIC ECHOCARDIOGRAPHY IN THE EARLY DIAGNOSIS OF INFECTIVE ENDOCARDITIS IN PEDIATRICS". Iranian Heart Journal, 5, 3, 2004, 16-22.
HARVARD
ZEAINLOU, A., MIRKHANI, H., NIAZI, M. (2004). 'THE ROLE OF TRANSTHORACIC ECHOCARDIOGRAPHY IN THE EARLY DIAGNOSIS OF INFECTIVE ENDOCARDITIS IN PEDIATRICS', Iranian Heart Journal, 5(3), pp. 16-22.
VANCOUVER
ZEAINLOU, A., MIRKHANI, H., NIAZI, M. THE ROLE OF TRANSTHORACIC ECHOCARDIOGRAPHY IN THE EARLY DIAGNOSIS OF INFECTIVE ENDOCARDITIS IN PEDIATRICS. Iranian Heart Journal, 2004; 5(3): 16-22.