重视儿童感染性心内膜炎的诊治

Diagnosis and treatment of infectious endocarditis in children

儿童感染性心内膜炎(infective endocarditis,IE)是一种累及自心内膜和/或心脏瓣膜的感染,尽管儿童IE总体发生率不高,一旦发生具有较高致死率,需对IE进行早期识别,避免因误诊、漏诊所导致的病情延误。另一方面,对于IE治疗抗生素的选择,手术介入的时机对于患者预后至关重要。曹清教授团队发表的1例复杂先天性心脏病术后并发重症IE的案例分析(《临床儿科杂志》2024年第42卷第8期),向读者展示了儿童IE的诊治过程中的困难与艰辛。本文将结合案例,介绍儿童IE的临床特征,讨论儿童IE治疗方案,进一步加深临床医师对儿童IE的认识。

Infective endocarditis(IE)is an infection originating from the endocardium and/or heart valves.Although the overall incidence of IE in children is relatively low,it carries a high mortality once happened.Timely identification and prompt treatment are crucial to avert adverse clinical outcomes.In recent issue,Prof.Cao et al.reported a case of IE caused by methicillin-resistant Staphylococcus aureus after congenital heart disease operation(J Clin Pediatr Vol.42 No.8 Aug.2024),which underscored the complexities and challenges involved in diagnosing and managing IE in pediatric patients.Herein,we will further discuss the clinical features,antibiotic options,and optimal timing of surgical intervention for pediatric IE,aiming to enhance clinicians'understanding of this condition.