Berna Şaylan ÇEVİK, Türkay SARITAŞ, Timur MEŞE, Vedide TAVLI

İnfektif endokardit saptanan çocuklarda klinik, laboratuvar ve ekokardiyografik parametrelerin retrospektif değerlendirilmesi

AMAÇ: İnfektif endokardit (İE) konjenital kalp hastalığı olan çocuklarda nadir görülen bir infeksiyondur. Bu çalışmanın amacı hastalığın erken tanı ve tedavisindeklinik şüphenin önemini ortaya koymaktır.Metod: Çalışmaya Ocak 2003-Temmuz 2005 tarihleri arasında infektif endokarditşüphesi olan yaşları 8 ay-14 yaş (ortalama 4.2±0.9) olan 28 hasta alındı. HastalarDuke kriterleri kullanılarak değerlendirildi. Klinik ve laboratuar bulguları, kan kültürleri ve ekokardiyografk değerlendirmeleri retrospektif olarak yapıldı. Hiçbir hastaya öncesinde dental veya cerrahi girişim uygulanmamıştı.Bulgular: Hastalarımızdan %14.3’ünün kültürlerinde koagulaz (+) staphylococcusaureus üredi. Duke kriterleri kullanılarak, sadece %14.2 hastada kesin infektif endokardit, diğerlerinde olası infektif endokardit tespit edildi.Tartışma-Sonuç: Duke kriterleri bazı hastaların tanısında anlamlıdır. İnfektif endokardit erken tanı ve tedavisinde en önemli basamak klinik şüphedir.

Retrospective evaluation of clinical, laboratory, and echocardiographic parameters of infective endocardi- tis in children

Purpose: Infective endocarditis (IE) is a rare infection in children with congenitalheart disease. The aim of this study was to defne clinical suspicion as the most important criterion for its early diagnosis and treatment. Method: Patients aged 8 months-14 years (mean 4.2±0.9) supposed to have infectiveendocarditis between January 2003 and July 2005 were included in the study. Theywere analyzed using the Duke criteria. Clinical and laboratory results, blood cultures,and echocardiographic fndings were evaluated retrospectively. None of the patientshad undergone dental or surgical procedures.Results: In our series, 14.3% of the cultures were positive for coagulase positiveStaphylococcus aureus. Using the Duke criteria, only 14.2% patients had defnite IE,while the others had possible IE.Conclusıon: The Duke criteria for the diagnosis of IE are relevant only for somepatients. Clinical suspicion must be the most important step in the early diagnosisand treatment.

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