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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 investigate the clinical features of infective endocarditis in children. Methods The clinical manifestations, etiology and echocardiography of 12 children with infective endocarditis were retrospectively analyzed. The clinical features of the disease were summarized. Results All children had fever symptoms, with anemia in 9 cases, with cerebral embolism in 1 case; 6 cases without heart disease, 4 cases of new heart murmur; 11 cases of peripheral leukocytes increased, 12 cases of neutrophils 6 cases were positive in blood culture, including 2 cases of Streptococcus pneumoniae and Staphylococcus aureus, 1 case of Streptococcus viridans and 1 case of dry Neisseria gonorrhoeae respectively; Ultrasound showed abnormalities, 1 case of valve rupture, 11 cases of visible neoplasms; vancomycin and other anti-infective treatment, 4 cases improved, 8 cases transferred or abandoned treatment of death. Conclusions Fever, anemia and heart murmur are the main clinical manifestations of infective endocarditis in children. Peripheral blood leukocytes, C-reactive protein and erythrocyte sedimentation rate may be increased in children. Staphylococcus aureus and streptococcus are common pathogens, echocardiography Diagnosis has important value.