Diagnóstico y protocolos de tratamiento de la endocarditis bacteriana en pacientes pediátricos

Abstract

Background: Bacterial endocarditis is a pathology that affects the endocardium and is most common in congenital heart disease due to the high probability of infection in prosthetic valves, pacemakers, and grafts. Objective: To describe the diagnosis and treatment protocols of bacterial endocarditis in pediatric patients. Methods: A review of the literature was performed, and the information was searched in several articles published in scientific databases such as PubMed, Science Direct, and Scopus; using the keywords: Heart valve disease, imaging techniques, bacterial endocarditis, pediatrics; using Boolean operators for more precise information (AND, NOT, ABS, TITLE, KEY). The information was limited to bacterial endocarditis in pediatrics; the results obtained were filtered with inclusion and exclusion criteria according to the years of publication (2017 - 2023). Results: Bacterial endocarditis is a pathology with high mortality. The incidence of endocarditis is 0.05 - 0.12 / 1000 cases reported in hospitalized patients, with slight variations according to each country. It is a complication of pre-existing congenital heart disease in up to 90% of cases, and 8-10% of all cases occur without pre-existing cardiac involvement. The most common clinical symptoms are heart murmurs, fever, fatigue, anorexia, dyspnea, weight loss, petechiae, Janeway lesions and Roth's spots, headache, dizziness, and myalgia. The therapeutic approach is based on combinations of antibiotics such as third-generation cephalosporins, aminoglycosides, carbapenems, and glycopeptides. The therapy should be maintained until the intracardiac vegetation becomes sterile, and it should be noted that the patients who required surgical treatment had a favorable evolution.