Referat

Infective Endocardtis in Pediatric 

Written by :
Nadya Hasna Rasyida DA
G4A017059

Advisor :
dr. Nenden Nursyamsi Agustina., Sp,A

MINISTRY OF RESEARCH, EDUCATION AND TECHNOLOGY

JENDERAL SOEDIRMAN UNIVERSITY
FACULTY OF MEDICINE
PURWOKERTO
2019
 Background
-Elder people
-CHD
-Prostestic valve AHA : 1/1280
Incidence (0.76/1000)
rate

-Preventive
-30% Mortality
-sudden death Rate
-Infection
-Endocardium
Endocarditis -Microba
-Bacterial
Definition
 Etiology

- Haemophilus sp
Fungi - Aggregatibacter sp
(2.4%) -
-
Cardiobacterium sp
Eikenella sp
Gram – - Kinggela sp
(5.2%)
Gram +
-Viridan group streptococcus (79.3%)
-Staphylococcus aureus
-Enterococcus sp
 Risk Factors
High Risk Patient :
• Prostetic valve
• History of endocarditis
• CHD
• CKD with haemodialisa

High Risk
Procedure
• Dental & oral
procedure
• IV catheter
Pathogenesis
Diagnostic
Diagnostic
Diagnostic
 Diagnostic

-Fatigue
-Fever
-Atralgia
-Myalgia
Anamnesis Physycal
examination

-Bacterimia
-Valvulitis
-Immunologic response
-Emboli
Diagnostic

Roth’s spot
 Diagnostic
TTE  Endocarditis in
pediatric
TEE  Valve
abnormalities

Laboratory Echocardiography

-Blood culture must be

done
-Laboratory testing not
giving the high spesifity
result
 Treatment
20 mg/kgBB

Clindamicyn

Amoxicillin Ceftriaxone

50 mg/kgBB 50 mg/kgBB

Profilaksis

Reduce bacteremia, not enough evidence for decrease incidence

Oral Streptococcus & Streptococcus bovis

Treatment
 Treatment
Oral Streptococcus & Streptococcus bovis
Treatment for Staphyloccocus sp
Treatment for Staphyloccocus sp
Treatement for enterococcus
Negative blood culture

Treatment
Before blood culture

Treatement
 Complication

Intracardial Extracardial
 Prognostic

80-90%
1 year
survival
rate

Patient
condition
60-70%
70-80%
2 years 5 years
survival survival
rate rate
 Bibliography
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2015;8688(20):1–10.
2. Baddour LM, Beerman LB, Jackson MA, Lockhart PB, Pahl E, Schutze GE. Infective Endocarditis in Childhood : 2015 Update.
Circulation. 2015;1487–515.
3. Hwang J, Park SW, Cho EJ, Lee GY, Kim EK, Chang S, et al. Risk factors for Poor Prognosis in Nosocomial Infective
Endocarditis. Korean J Intern Med. 2018;33:102–12.
4. Braam R. Prognostic Factors in Infective Endocarditis in General Hospitals in the Netherlands. Netherl Hear J. 2016;24:717–
21.
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Twenty Years . An Analysis of 241 Cases. Infect Dis. 2015;88(3):321–6.
7. Satya G. Guidelines on Prevention, Diagnosis and Treatment of Infective Endocarditis. Gujarat Med J. 2010;65(2):43–8.
8. Medicine N, Grazia M, France JC, Del F, El G, Anna P, et al. 2015 ESC Guidelines for the Management of Infective
Endocarditis. Eur Heart J. 2015;1–54.
9. Elder RW. The Changing Epidemiology of Pediatric Endocarditis. Infect Dis Clin NA. Elsevier Inc; 2015;29(3):513–24.
10. Isaksson J, Rasmussen M, Nilson B, Svensson L, Kurland S, Olaison L, et al. Comparison of Species Identifi cation of
Endocarditis Associated Viridans Streptococci using rnpB Genotyping and 2 MALDI-TOF systems. Diagn Microbiol Infect Dis
[Internet]. Elsevier Inc.; 2015;81(4):240–5. Diambil dari: http://dx.doi.org/10.1016/j.diagmicrobio.2014.12.007
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Appliance Managed Surgically by Mitral Valve Plasty. Med J. 2018;97(27):1–4.
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 Bibliography
1. Moges T. Infective Endocarditis in Ethiopian Children: a Hospital Based Review of Cases in Addis Ababa. Pan Africa Med J. 2015;8688(20):1–10.
2. Baddour LM, Beerman LB, Jackson MA, Lockhart PB, Pahl E, Schutze GE. Infective Endocarditis in Childhood : 2015 Update. Circulation. 2015;1487–515.
3. Hwang J, Park SW, Cho EJ, Lee GY, Kim EK, Chang S, et al. Risk factors for Poor Prognosis in Nosocomial Infective Endocarditis. Korean J Intern Med. 2018;33:102–12.
4. Braam R. Prognostic Factors in Infective Endocarditis in General Hospitals in the Netherlands. Netherl Hear J. 2016;24:717–21.
5. Thuny F, Grisoli D, Cautela J, Riberi A, Raoult D, Habib G. Infective Endocarditis : Prevention, Diagnosis and Management. Can J Cardiol. Elsevier Ltd; 2014;
6. Rancea R, Capalneanu R, Lupse M. Assessment Of The Duke Criteria for the Diagnosis of Infective Endocarditis After Twenty Years . An Analysis of 241 Cases. Infect Dis.
2015;88(3):321–6.
7. Satya G. Guidelines on Prevention, Diagnosis and Treatment of Infective Endocarditis. Gujarat Med J. 2010;65(2):43–8.
8. Medicine N, Grazia M, France JC, Del F, El G, Anna P, et al. 2015 ESC Guidelines for the Management of Infective Endocarditis. Eur Heart J. 2015;1–54.
9. Elder RW. The Changing Epidemiology of Pediatric Endocarditis. Infect Dis Clin NA. Elsevier Inc; 2015;29(3):513–24.
10. Isaksson J, Rasmussen M, Nilson B, Svensson L, Kurland S, Olaison L, et al. Comparison of Species Identifi cation of Endocarditis Associated Viridans Streptococci using rnpB
Genotyping and 2 MALDI-TOF systems. Diagn Microbiol Infect Dis [Internet]. Elsevier Inc.; 2015;81(4):240–5. Diambil dari: http://dx.doi.org/10.1016/j.diagmicrobio.2014.12.007
11. Birlutiu V, Birlutiu RM, Costache VS. Viridans Streptococcal Infective Endocarditis Associated with Fixed Orthodontic Appliance Managed Surgically by Mitral Valve Plasty. Med
J. 2018;97(27):1–4.
12. Brooks GF. Jawetz, Melnick & Adelberg’s Medical Microbiology, 25th Edition. Jakarta: EGC; 2010.
13. Otto M. Staphylococcus Aureus Toxins. Curr Opin Microbiol. Elsevier Ltd; 2014;17:32–7.
14. Keller K, Bardeleben RS Von, Ostad MA, Hobohm L, Munzel T, Konstantinides S, et al. Temporal Trends in the Prevalence of Infective Endocarditis in Germany between 2005
and 2014. Am J Cardiol. Elsevier Ltd; 2016;
15. Dayer MJ, Jones S, Prendergast B, Baddour LM, Lockhart PB, Thornhill MH. Incidence of Infective Endocarditis in England , 2000 – 13 : a Secular Trend , Interrupted Time-Series
Analysis. Lancet. Elsevier Ltd; 2014;6736(14):1–10.
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Prospective Study. Cardiovasc Diagn Ther. 2017;7(1):27–35.
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21. Orvin K, Goldberg E, Bernstine H, Groshar D, Sagie A, Kornowski R, et al. The role of FDG-PET / CT Imaging in Early Detection of Extra-cardiac Complications of Infective
Endocarditis. Clin Microbiol Infect. Elsevier; 2014;1–8.
22. Ware AL, Tani LY, Weng H, Wilkes J, Menon SC. Resource Utilization and Outcomes of Infective Endocarditis in Children. J Pediatr. Elsevier Inc; 2014;165(4):807–812.e1.
THANK YOU