A forty-year review of bacterial endocarditis in infancy and childhood.

Abstract

A retrospective review of 149 episodes of bacterial endocarditis (BE) in 141 patients under 25 years of age, at The Children's Hospital Medical Center from 1933 through June of 1972, demonstrates increasing survival and a distinct change in the frequency of underlying congenital heart disease and rheumatic heart disease (RHD). Certain forms of congenital heart disease such as tetralogy of Fallot, small ventricular septal defect, and aortic stenosis are at particular risk for BE. Following BE, patients with ventricular septal defect and tetralogy of Fallot have less morbidity and higher survival rates than children with aortic outflow lesions. over the entire time period, alpha Streptococcus is the most common pathogen and Staphylococcus aureus, second most frequent organism. Surgical correction in patients with congenital heart disease may offer the best form of prevention.

Original article. Childhood infective endocarditis in Khon Kaen University Hospital from 1992 to 2011

“…The majority of organisms causing IE in this study were gram-positive cocci (85%) and this finding is in accordance with findings in other studies [2][3][4][5][6]. Considerable data support the hypothesis that the interactions of gram-positive cocci with platelets and the capacity of these organism to resist the host defense properties of platelets are pivotal in the occurrence and persistence of IE [1,15].…”

“…IE as a result of S. aureus infection has been reported to be associated with a poor prognosis [1][2][3][4][5]. This association was confirmed in the present study because S. aureus was involved in 5 of 6 deaths in this cohort.…”

“…It is a significant cause of morbidity and mortality in children and adolescents despite advances in the management and prophylaxis of the disease with antimicrobial agents [2][3][4][5]. Although IE is relatively uncommon in children compared with adults, accounting for 0.5−0.8 cases per 1,000 pediatric admissions [1][2][3][4][5], the incidence of pediatric IE is believed to be increasing [1]. This is due in part to improved survival among children who are at risk for IE, such as those with congenital heart disease (CHD) and hospitalized newborn infants [1][2][3][4].…”

“…Although IE is relatively uncommon in children compared with adults, accounting for 0.5−0.8 cases per 1,000 pediatric admissions [1][2][3][4][5], the incidence of pediatric IE is believed to be increasing [1]. This is due in part to improved survival among children who are at risk for IE, such as those with congenital heart disease (CHD) and hospitalized newborn infants [1][2][3][4]. Moreover, increasing use of synthetic materials in children with heart diseases and frequent use of indwelling central venous catheters for the care of critically ill infants and children are supposed to increase the risk for development of IE [1][2][3][4][5].…”

“…Moreover, newer diagnostic guidelines, availability of newer antibiotics and advances in cardiovascular surgery have resulted in better survival outcomes of IE in developed countries [2][3][4][5][6].…”