Value and Limitations of the von Reyn, Duke, and Modified DukeVon Criteria for the Diagnosis of Infective Endocarditis in ChildrenReyn公爵的，价值和局限性，和Modified Duke 小儿感染性心内膜炎的诊断标准规范.pdfVIP

Value and Limitations of the von Reyn, Duke, and Modified Duke Criteria for the Diagnosis of Infective Endocarditis in Children Pierre Tissie`res, MD*; Alain Gervaix, MD‡; Maurice Beghetti, MD*; and Edgar T. Jaeggi, MD* ABSTRACT. Objective. To compare the sensitivity of he clinical diagnosis of infective endocarditis 3 different criteria—von Reyn, Duke, and modified (IE) may be challenging, which explains the Duke—in diagnosing infective endocarditis (IE) in chil- Tneed for a precise and uniform diagnostic ap- dren. proach. The initial classification elaborated by von Study Design. Retrospective case study in a tertiary Reyn and colleagues1 was based primarily on clinical pediatric hospital. and pathologic findings including demonstration of Methods and Results. Between 1985 and 2001, 41 epi- the infection by histopathology or positive blood sodes of IE were documented in 40 children (median: 7 cultures (BCs). The von Reyn classification, invented years old; range: 1 week to 18 years). The diagnosis was before the introduction of two-dimensional and based on echocardiographic and microbiologic or patho- Doppler ultrasonography, does not consider charac- logic findings. The initial echocardiogram suggested IE teristic echocardiographic findings related to endo- in 95% of the cases. Main findings were vegetations in 36, cardial infection, which may explain its limited value perivalvular abscess in 4, and/or new valvular leaks in 6 in d