Infant and Childhood Infective Endocarditis in the Western Cape, South Africa: A Retrospective Review
| dc.contributor.advisor | Zühlke, Liesl | |
| dc.contributor.advisor | Comitis, George | |
| dc.contributor.advisor | Fourie, Barend | |
| dc.contributor.advisor | Lawrenson, John | |
| dc.contributor.advisor | Perkins, Susan | |
| dc.contributor.advisor | Basera, Wisdom | |
| dc.contributor.author | Willoughby, Mark | |
| dc.date.accessioned | 2021-03-03T06:29:56Z | |
| dc.date.available | 2021-03-03T06:29:56Z | |
| dc.date.issued | 2020 | |
| dc.date.updated | 2021-03-02T19:38:30Z | |
| dc.description.abstract | Introduction Infective endocarditis is a microbial infection of the endothelial surface of the heart, predominantly the heart valves, that is associated with high mortality and morbidity. Few contemporary data exist regarding affected children in our context. Aims and Objectives: We aimed to describe the profile and treatment outcomes of infant and childhood endocarditis at our facilities. Methods: This is a retrospective review of infants and children with endocarditis at two public-sector hospitals in the Western Cape Province of South Africa over a 5-year period. Patients with “definite” and “possible” endocarditis according to Modified Duke Criteria were included in the review. Results: Forty-nine patients were identified for inclusion; 64% of patients met “definite” and 36% “possible” criteria. The in-hospital mortality rate was 20%; 53% of patients underwent surgery with a post-operative mortality rate of 7.7%. The median interval from diagnosis to surgery was 20 days (interquartile range 9-47 days). Valve replacement occurred in 28% and valve repair in 58%. There was a significant reduction in valvular dysfunction in patients undergoing surgery and only a marginal improvement in patients treated medically. Overall, 43% of patients had some degree of residual valvular dysfunction. Conclusion: Endocarditis is a serious disease with a high in-hospital mortality and presents challenges in making an accurate diagnosis. Despite a significant reduction in valvular dysfunction, a portion of patients had residual valvular dysfunction. Early surgery is associated with a lower mortality rate, but a higher rate of valve replacement when compared to delayed surgery. | |
| dc.identifier.apacitation | Willoughby, M. (2020). <i> Infant and Childhood Infective Endocarditis in the Western Cape, South Africa: A Retrospective Review</i>. (). ,Faculty of Health Sciences ,Department of Paediatrics and Child Health. Retrieved from http://hdl.handle.net/11427/33093 | en_ZA |
| dc.identifier.chicagocitation | Willoughby, Mark. <i>"Infant and Childhood Infective Endocarditis in the Western Cape, South Africa: A Retrospective Review."</i> ., ,Faculty of Health Sciences ,Department of Paediatrics and Child Health, 2020. http://hdl.handle.net/11427/33093 | en_ZA |
| dc.identifier.citation | Willoughby, M. 2020. Infant and Childhood Infective Endocarditis in the Western Cape, South Africa: A Retrospective Review. . ,Faculty of Health Sciences ,Department of Paediatrics and Child Health. http://hdl.handle.net/11427/33093 | en_ZA |
| dc.identifier.ris | TY - Master Thesis AU - Willoughby, Mark AB - Introduction Infective endocarditis is a microbial infection of the endothelial surface of the heart, predominantly the heart valves, that is associated with high mortality and morbidity. Few contemporary data exist regarding affected children in our context. Aims and Objectives: We aimed to describe the profile and treatment outcomes of infant and childhood endocarditis at our facilities. Methods: This is a retrospective review of infants and children with endocarditis at two public-sector hospitals in the Western Cape Province of South Africa over a 5-year period. Patients with “definite” and “possible” endocarditis according to Modified Duke Criteria were included in the review. Results: Forty-nine patients were identified for inclusion; 64% of patients met “definite” and 36% “possible” criteria. The in-hospital mortality rate was 20%; 53% of patients underwent surgery with a post-operative mortality rate of 7.7%. The median interval from diagnosis to surgery was 20 days (interquartile range 9-47 days). Valve replacement occurred in 28% and valve repair in 58%. There was a significant reduction in valvular dysfunction in patients undergoing surgery and only a marginal improvement in patients treated medically. Overall, 43% of patients had some degree of residual valvular dysfunction. Conclusion: Endocarditis is a serious disease with a high in-hospital mortality and presents challenges in making an accurate diagnosis. Despite a significant reduction in valvular dysfunction, a portion of patients had residual valvular dysfunction. Early surgery is associated with a lower mortality rate, but a higher rate of valve replacement when compared to delayed surgery. DA - 2020_ DB - OpenUCT DP - University of Cape Town KW - Paediatric Cardiology LK - https://open.uct.ac.za PY - 2020 T1 - ETD: Infant and Childhood Infective Endocarditis in the Western Cape, South Africa: A Retrospective Review TI - ETD: Infant and Childhood Infective Endocarditis in the Western Cape, South Africa: A Retrospective Review UR - http://hdl.handle.net/11427/33093 ER - | en_ZA |
| dc.identifier.uri | http://hdl.handle.net/11427/33093 | |
| dc.identifier.vancouvercitation | Willoughby M. Infant and Childhood Infective Endocarditis in the Western Cape, South Africa: A Retrospective Review. []. ,Faculty of Health Sciences ,Department of Paediatrics and Child Health, 2020 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/33093 | en_ZA |
| dc.language.rfc3066 | eng | |
| dc.publisher.department | Department of Paediatrics and Child Health | |
| dc.publisher.faculty | Faculty of Health Sciences | |
| dc.subject | Paediatric Cardiology | |
| dc.title | Infant and Childhood Infective Endocarditis in the Western Cape, South Africa: A Retrospective Review | |
| dc.type | Master Thesis | |
| dc.type.qualificationlevel | Masters | |
| dc.type.qualificationlevel | MPhil |