Clinical features and predictors of diphtheritic cardiomyopathy in Vietnamese children.
BACKGROUND: Despite the availability of antitoxin and antibiotics, the mortality rate for diphtheria remains high, mostly because of cardiac complications. METHODS: During 1 year, 154 Vietnamese children with diphtheria admitted to a referral hospital were studied prospectively with clinical examin...
| Main Authors: | , , , , , , , , , , |
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| Format: | Journal article |
| Language: | English |
| Published: |
2004
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| _version_ | 1797094048618512384 |
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| author | Kneen, R Nguyen, MD Solomon, T Pham, N Parry, C Nguyen, T Ha, T Taylor, A Vo, T Nguyen, T Day, N White, N |
| author_facet | Kneen, R Nguyen, MD Solomon, T Pham, N Parry, C Nguyen, T Ha, T Taylor, A Vo, T Nguyen, T Day, N White, N |
| author_sort | Kneen, R |
| collection | OXFORD |
| description | BACKGROUND: Despite the availability of antitoxin and antibiotics, the mortality rate for diphtheria remains high, mostly because of cardiac complications. METHODS: During 1 year, 154 Vietnamese children with diphtheria admitted to a referral hospital were studied prospectively with clinical examination, including a simple pseudomembrane score, 12-lead and 24-hour electrocardiography, measurement of serum cardiac enzyme levels, and estimation of troponin T levels. RESULTS: Thirteen children had diphtheritic cardiomyopathy on admission, and 19 developed it subsequently. Twelve children (8%) died. The combination of pseudomembrane score of >2 and bull neck predicted the development of diphtheritic cardiomyopathy, with a positive predictive value of 83% and a negative predictive value of 93%. Administration of 24-hour electrocardiography on admission improved the ability to predict diphtheritic cardiomyopathy by 57%. Fatal outcome was best predicted by the combination of myocarditis on admission and a pseudomembrane score of >2. Of the cardiac enzyme levels measured, an elevated aspartate aminotransferase level was the best predictor. The presence of troponin T identified additional children with subclinical cardiac damage. CONCLUSIONS: The development of diphtheritic cardiomyopathy can be predicted by means of simple measures. |
| first_indexed | 2024-03-07T04:08:43Z |
| format | Journal article |
| id | oxford-uuid:c7174e5c-a3bc-41d0-a5b5-fbf5e5aca7ae |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T04:08:43Z |
| publishDate | 2004 |
| record_format | dspace |
| spelling | oxford-uuid:c7174e5c-a3bc-41d0-a5b5-fbf5e5aca7ae2022-03-27T06:42:44ZClinical features and predictors of diphtheritic cardiomyopathy in Vietnamese children.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:c7174e5c-a3bc-41d0-a5b5-fbf5e5aca7aeEnglishSymplectic Elements at Oxford2004Kneen, RNguyen, MDSolomon, TPham, NParry, CNguyen, THa, TTaylor, AVo, TNguyen, TDay, NWhite, N BACKGROUND: Despite the availability of antitoxin and antibiotics, the mortality rate for diphtheria remains high, mostly because of cardiac complications. METHODS: During 1 year, 154 Vietnamese children with diphtheria admitted to a referral hospital were studied prospectively with clinical examination, including a simple pseudomembrane score, 12-lead and 24-hour electrocardiography, measurement of serum cardiac enzyme levels, and estimation of troponin T levels. RESULTS: Thirteen children had diphtheritic cardiomyopathy on admission, and 19 developed it subsequently. Twelve children (8%) died. The combination of pseudomembrane score of >2 and bull neck predicted the development of diphtheritic cardiomyopathy, with a positive predictive value of 83% and a negative predictive value of 93%. Administration of 24-hour electrocardiography on admission improved the ability to predict diphtheritic cardiomyopathy by 57%. Fatal outcome was best predicted by the combination of myocarditis on admission and a pseudomembrane score of >2. Of the cardiac enzyme levels measured, an elevated aspartate aminotransferase level was the best predictor. The presence of troponin T identified additional children with subclinical cardiac damage. CONCLUSIONS: The development of diphtheritic cardiomyopathy can be predicted by means of simple measures. |
| spellingShingle | Kneen, R Nguyen, MD Solomon, T Pham, N Parry, C Nguyen, T Ha, T Taylor, A Vo, T Nguyen, T Day, N White, N Clinical features and predictors of diphtheritic cardiomyopathy in Vietnamese children. |
| title | Clinical features and predictors of diphtheritic cardiomyopathy in Vietnamese children. |
| title_full | Clinical features and predictors of diphtheritic cardiomyopathy in Vietnamese children. |
| title_fullStr | Clinical features and predictors of diphtheritic cardiomyopathy in Vietnamese children. |
| title_full_unstemmed | Clinical features and predictors of diphtheritic cardiomyopathy in Vietnamese children. |
| title_short | Clinical features and predictors of diphtheritic cardiomyopathy in Vietnamese children. |
| title_sort | clinical features and predictors of diphtheritic cardiomyopathy in vietnamese children |
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