Difficulties in Diagnosis and Therapy of Infective Endocarditis in Children and Adolescents-Cohort Study

Despite the progress in management and prophylaxis measures, infective endocarditis (IE) is still a condition associated with high mortality rates and severe complications. Fortunately, the incidence of IE is much lower in children and adolescents, with only 0.05-0.12/1000 cases being reported in hospitalized pediatric patients. According to recent data, IE is, in most cases, a complication of pre-existing congenital heart disorders, in up to 75-90% of cases. About 8-10% of all IE cases occur in children without a pre-existing heart condition, due to the widespread use of catheters and invasive procedures, or are associated with immunosuppression. The overall mortality rate due to IE among children and adolescents is 16-25%, a fairly high incidence despite advances made in management and treatment methodologies. We present a retrospective case study conducted in the Pediatric Cardiology Department of 'St. Maria' Emergency Children's Hospital of Iași between February 2007 and February 2020, including 54 children aged between 23 days and 17 years. Our study was aimed at revealing the evolution of IE in recent years in the pediatric population, at identifying the main causes leading to the onset and progress of the disease, at assessing the incidence of clinical and paraclinical manifestations and at determining efficient diagnosis and therapy approaches for the population under survey.