الفهرس 
Introduction and aim of the workOnly 14 pages are availabe for public view
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Abstract
IE is a relatively rare but life-threatening disease (Bin Abdulhak et al., 2014). The complexities of patient management in neonatal and pediatric intensive care units have increased the risk of IE in children with structurally normal hearts (Baltimore, 2002) from 1st of July 2019 to 31st of August 2020, a total of 30 children and adolescents admitted in Assiut University Children Hospital and suspected as infective endocarditis patients were enrolled in an observational study. The purpose of this study was to examine to what extent our policy in diagnosing IE in Assuit University Children’s Hospital goes in concordance with international guidelines of modified DUKE criteria.The mean age of definite and possible IE patients was 5.4 years and 6.7 years respectively. All definite and possible IE patients were males (100%). Among possible IE patients, 66.7% (6 patients) had known possible predisposing factors for IE. Blood culture was positive in 11.1% (1/9) in possible IE patients while definite IE patients showed positive blood culture in 66.7% (4/6). Among possible IE patients, majority of patients had no valvular damage [66.7% (6/9)]. Regarding definite IE patients, all patients had valvular damage. In addition, among possible IE patients, majority of patients had intracardiac vegetations [77.8% (7/9)]. Regarding definite IE patients, all patients (6/6) had intracardiac vegetations 100%.The conclusions and recommendations to be withdrawn from this study are: It should be said that IE remains still as a problem for contemporary medicine and in particular pediatric cardiology. Due to the acute and complicated course, high awareness among pediatricians and prompt diagnosis are crucial. Appropriate medical management may require early diagnosis to prevent complications and enhance fast recovery. Staphylococcus is the most commonly isolated organism in blood cultures in patients with IE. Any patient suspected of having infective endocarditis by clinical criteria should be screened by TTE. When the images are of good quality and the study is negative, an alternative diagnosis should be sought if the clinical suspicion is low. If the clinical suspicion is high TEE should be performed. TEE should also be performed if the results of the TTE are equivocal owing to underlying structural abnormalities or poor acoustic windows. If the TEE is negative, observation or re-evaluation of the clinical data are warranted. If the suspicion of endocarditis is high TEE should be repeated after 7–10 days to allow potential vegetations to become more apparent. A repeated negative study should virtually rule out the diagnosis unless TEE images are of poor quality. TEE should also be performed to provide a more detailed anatomical assessment when there is a suspicion of perivalvar complications, particularly in the setting of aortic or prosthetic valve endocarditis, or in infections caused by virulent organisms such as Staphylococcus aureus