Ayder Comprehensive Specialized Hospital, Ethiopia
Title: Clinical presentation and outcome of infective endocardtis in children admitted at aydercomprehensive specialized hospital
Biography: Abel Gidey Kebedom
Background: Infective endocarditis, microbial infection of the endocardial surface of the heart, is the most feared complication of the structural heart lesions. Death due to infective endocarditis has been reported to be as high as 26% in sub-Saharan Africa. In Ethiopia, the prevalence of RHD in school children is about 19 per 1000 with mean age at death of 25.9 years in hospital inpatients. The mortality rate is augmented by conditions like infective endocarditis on which no regional data available.
Objective: To assess clinical presentation and determine outcome of infective endocarditis in Ayder Specialized Comprehensive Hospital from September 2011 to March 2018.
Materials & Methods: We retrospectively reviewed patient chart and analyzed with Chi-square test.
Result: An aggregate of 74 pediatric patients with infective endocarditis were seen in the study period males found 52.7% (39/74) of the population. More than half (54%) were in the age range 11 to 18 years. Rheumatic heart disease was the underlying condition in majority of the cases accounting 59 (79.8%). Clinical presentations included: Fever 60 (82.1%), pallor 59 (79.7%), splenomegaly 17 (23%) and clubbing 10 (13.6%). Complications were congestive heart failure 51 (68.9%), neurological findings 10 (8.1%) and renal complication (1.4%). There were 12 deaths with overall case fatality rate of 16.2%. Embolic phenomenon and shorter hospital stay harbors higher morbidity and mortality with P-value <0.001 and P -value 0.01 respectively.
Conclusion: In our setup, IE in children is still characterized by the high prevalence of RHD as an underlying heart disease. Fever, murmur and pallor were the commonest clinical presentation. Higher mortality was seen because of delayed referral and delayed presentation. Late presentations of cases were evidenced by high proportion of complications such as congestive heart failure and death with short hospital stay. Embolic phenomenon was also significantly associated with death.