摘要
目的探讨儿童感染性心内膜炎的临床特点。方法回顾性分析12例儿童感染性心内膜炎患者临床表现、病原学、心脏超声等结果,总结疾病临床特点。结果患儿均有发热症状,合并贫血9例,伴脑栓塞1例;6例未合并心脏基础疾病者,4例有新出现的心脏杂音;11例外周血白细胞升高,12例中性粒细胞、C反应蛋白水平升高,8例血沉升高;血培养阳性6例,其中肺炎链球菌、金黄色葡萄球菌感染各2例,草绿色链球菌、干燥奈瑟球菌感染各1例;心脏超声均提示异常,1例瓣膜裂,11例可见赘生物;经万古霉素等抗感染治疗,4例好转,8例转院或放弃治疗死亡。结论发热、贫血、心脏杂音为儿童感染性心内膜炎的主要临床表现,患儿外周血白细胞、C反应蛋白、血沉可升高,金黄色葡萄球菌和链球菌为常见病原菌,心脏超声检查对诊断有重要价值。
Objective To study the clinical characteristics of infective endocarditis in children. Methods The clinical manifestations, pathogens and cardiac ultrasonographic finding were retrospectively analyzed in 12 patients with infective endocarditis to summarize its clinical characteristics. Results All patients had fever, 9 were complicated with anemia, and I was complicated with cerebral embolism. In 6 patients with no congenital heart disease, 4 had newly-presented cardiac murmur. The white blood cell was elevated in 11 patients. Neutrophil and C-reactive protein were elevated in all patients, and erythrocyte sedimentation rate was elevated in 8 patients. Blood culture was positive in 6 patients, in which 2 patients were infected by Streptococcus, 2 by Staphylococcus, 1 by Streptococcus viridans and 1 by Neisseria gonorrhoeae. Cardiac ultrasonography showed 1 patient with aeeration of cardiacvalve and 11 with neoplasm. After treatment by antibiotics including vaneomycin, 4 patients were alleviated, and 8 were transferred to high-level hospital or died due to giving up treatment. Conclusion The main clinical characteristics of infective endocarditis in children are fever, anemia and neway-presented cardiac murmur. The white blood cell, C-reactive protein and erythrocyte sedimentation rate are elevated. Streptococcus and Staphylococcus are common pathogens. Echocardiography is valuable to the diagnosis.
出处
《中华实用诊断与治疗杂志》
2016年第8期792-794,共3页
Journal of Chinese Practical Diagnosis and Therapy
基金
深圳市医学重点学科建设基金资助(2005C05)
关键词
感染性心内膜炎
儿童
病原菌
心脏超声
Infective endocarditis
children
pathogen
echocardiography
