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细菌性心内膜炎(下简称BE)在儿科少见,据波士顿儿童医院报告其发生率为住院病人的0.55‰,儿童BE患者中80%有先心或风心,20～40%病例可证实曾行外科手术或有其他感染病灶,细菌可通过心脏、牙齿、五官、泌尿生殖道等途径进入血流,粘附于先前被异常血流喷射或心脏手术受过损害的办膜或内膜上,坏死的内膜、细菌、血小板、纤维在这些部位形成赘生物,其碎片可在远端部位栓塞,长期感染后可检得循环免疫复合物。BE的全身症状是办膜功能障碍、赘生物碎片栓塞和免疫复合物形成的结果。症状可在发病7天内产生,但BE常被延误诊断,有些患者在出现症状平均35天和才被诊断、发热、杂音、血沉快、体重下降、脾肿大是儿童BE患者最一致的表现。9～40%有心衰、神经系统症状占20～40%,
Bacterial endocarditis (BE) is rare in pediatrics. According to Boston Children’s Hospital, the incidence is 0.55% of inpatients, and 80% of children with BE have congenital or rheumatic heart disease. 20-40% of cases can be confirmed Have surgery or other lesions, bacteria through the heart, teeth, facial features, genitourinary tract and other means into the bloodstream, adhesion to the previous abnormal blood flow jet or cardiac surgery damaged film or endometrium, Necrosis of the endometrium, bacteria, platelets, fibers in these parts of the formation of neoplasms, the fragments can be embolized in the distal part of long-term infection can be detected after the cycle of immune complexes. The systemic symptoms of BE are the result of membrane dysfunction, vegetation debris embolism and immune complex formation. Symptoms can develop within 7 days of onset, but BE is often diagnosed as being delayed. Some patients are diagnosed on average for 35 days and have the most consistent appearance of BE in children with fever, murmur, fast erythrocyte sedimentation rate, and weight loss. 9 to 40% have heart failure, nervous system symptoms account for 20 to 40%