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.