No abstract

A closer approach to differential conditions of patients, according to age, intravenous drug use or the presence of prosthetic valves, is necessary.

La adolescencia corresponde a la edad en la que se producen los intensos cambios físicos y psicosociales que generalmente se inician y terminan dentro de la segunda década de la vida (1). La Organización Mundial de la Salud (OMS), considera adolescencia entre los 10 y los 19 años y juventud al perí-odo entre los 19 y los 25 años de edad. Precisa sin embargo, se trata de una "fase" más que un período fijo en la vida de un individuo, una fase en la que el individuo no es ya un niño pero todavía no es un adulto (2). En cuanto a la asistencia sanitaria en nuestro país, los Servicios Hospitalarios y de Atención Primaria de Pediatría prestan asistencia médica a las personas de hasta catorce años de edad (3,4). De acuerdo con

Pacemaker endocarditis is a rare but serious complication of permanent transvenous pacing. The most common presentation is fever syndrome or gram positive bacteremia. For the diagnostic it is important to performed blood cultures and an echocardiography. A retrospective study included the cases of pacemaker endocarditis diagnosed in the Internal Medicine Department of our Hospital between 1989-2003. Six patients were included. Repeated manipulation of the system and diabetes were the most frequent risk factors. The most frequently detected causative microorganisms were Staphylococci. In spite of the low sensitivity of the transthoracic echocardiography in expert hands it can improve, in this series it places in 66 %. Surgical treatment with cardiopulmonary bypass and implantation of a new system was performed in the same intervention in all patients. None relapsed and the overall mortality was 17%.

In the last years an increment has taken place in the pacemaker and implantable cardioverter-defibrillator indications that will have as consequence an increase of the prevalence of endocarditis associated to intravascular devices, for what acquires special relevance for the clinician to know this entity and to include it in his differential diagnoses. The objective of this article is to describe the epidemiology, clinic characteristics, diagnosis, treatment and outcome of the pacemaker endocarditis.