Affiliations: Morgan Stanley Children's Hospital of
NewYork-Presbyterian, New York, NY, USA | Department of Pediatrics, Columbia University Medical
Center, New York, NY, USA | Department of Infection Prevention and Control,
NewYork-Presbyterian Hospital, New York, NY, USA
Note: [] Correspondence: Stéphanie M. Levasseur, MD, Division of
Pediatric Cardiology, 3959 Broadway, CHONY 2 North, New York-Presbyterian
Hospital, New York, NY 10032, USA. Tel.: +1 212 305 2359; Fax: +1 212 305 4429;
E-mail: [email protected]
Abstract: We sought to assess whether children with pre-existing heart disease
treated for infective endocarditis (IE) were less likely to fulfill the
modified Duke criteria for definite IE than those without heart disease. While
the modified Duke criteria are widely accepted in research and clinical
diagnosis, their applicability in diagnosing IE in children is not as well
studied. We performed a retrospective single-center study of children treated
for IE from January 1999-December 2009 and compared the proportion of children
with and without heart disease who fulfilled modified Duke criteria for
definite IE. We also examined these criteria in children with cyanotic heart
disease, hospital-acquired IE, or recent cardiac surgery. Fifty (60%) of 84
children treated for IE met modified Duke criteria for definite IE. The
proportion of children with and without heart disease who fulfilled modified
Duke criteria for definite IE was not significantly different (38/68, 56%,
versus 12/16, 75%, respectively, p=0.26). Patients with cyanotic heart
disease or hospital-associated IE were as likely to meet definite criteria as
those without. However, children with early postoperative IE were less likely
than those with late postoperative or without cardiac surgery to meet definite
IE criteria (12/31, 39%, versus 38/53, 72%, p=0.005). Only 60% of children
treated for IE met modified Duke criteria for definite IE. Children with early
postoperative IE were least likely to fulfill these criteria. Future studies
should evaluate potential strategies to improve the diagnosis of IE in children.
