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Pediatric Cardiology

, Volume 15, Issue 3, pp 127–131 | Cite as

Spectrum of infective endocarditis during infancy and childhood: 20-Year review

  • J. Fukushige
  • H. Igarashi
  • K. Ueda
Original Articles

Summary

The medical records of the 29 patients under 18 years of age with infective endocarditis (IE) seen over a 20-year period by our department were reviewed to provide an overview of the spectrum of IE during infancy and childhood. None of the 29 patients had had previous cardiovascular surgery. The mean age at onset of IE was 7 years 2 months; 3 patients (10%) were under 2 years of age at onset. One patient during the early years died following 4 months of treatment with various antibiotics. Three patients underwent urgent surgery, and 17 patients with healed IE had elective surgery. All of the 20 patients who were operated on survived. The remaining 8 were followed with medical treatment alone. Positive blood cultures were obtained from 24 (83%) patients, and streptococci were still commonly found (38%). Ventricular septal defect (VSD) accounted for 66% of underlying heart diseases and rheumatic heart diseases for 14%. Vegetations were detected in 12 (67%) of 18 patients observed by echocardiography. Among these 12 patients, 1 with VSD underwent urgent tricuspid valve replacement and VSD closure because of worsening congestive heart failure due to progressive tricuspid regurgitation. Echocardiography identifies patients at high risk with IE, though the presence of a vegetation on echocardiography does not necessarily of itself dictate surgical intervention.

Key Words

Echocardiography Infective endocarditis 

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References

  1. 1.
    Awadallah SM, Kavey REW, Byrum CJ, Smith FC, Kveselis DA, Blackman MS (1991) The changing pattern of infective endocarditis in childhood.Am J Cardiol 68:90–94Google Scholar
  2. 2.
    Bayliss R, Clarke C, Oakley CM, Somerville W, Whitfield AGW (1983) The teeth and infective endocarditis.Br Heart J 50:506–512Google Scholar
  3. 3.
    Bayliss R, Clarke C, Oakley CM, Somerville W, Whitfield AGW, et al. (1983) The microbiology and pathogenesis of infective endocarditis.Br Heart J 50:513–519Google Scholar
  4. 4.
    Blumenthal S, Griffiths SP, Morgan RC (1960) Bacterial endocarditis in children with heart disease: a review based on the literature and experience with 58 cases.Pediatrics 26: 993–1017Google Scholar
  5. 5.
    Dillon T, Meyer RA, Korfhagen JC, Kaplan S, Chung KJ (1980) Management of infective endocarditis using echocardiography.J Pediatr 86:552–558Google Scholar
  6. 6.
    Durack DT, Kaplan EL, Bisno AL (1983) Apparent failure of endocarditis prophylaxis: analysis of 52 cases submitted to a national registry.JAMA 250:2318–2322Google Scholar
  7. 7.
    Johnson CM, Rhodes KH (1982) Pediatric endocarditis.Mayo Clin Proc 57:86–94Google Scholar
  8. 8.
    Johnson DH, Rosenthal A, Nadas AS (1975) A forty-year review of bacterial endocarditis in infancy and childhood.Circulation 51:581–588Google Scholar
  9. 9.
    Johnson DH, Rosenthal A, Nadas AS (1975) Bacterial endocarditis in children under 2 years of age.Am J Dis Child 129:183–186Google Scholar
  10. 10.
    Kramer HN, Burgenois M, Liersch R, Nebler L, Meyer H, Sievers G (1983) Current clinical aspects of bacterial endocarditis in infancy, childhood and adolescence.Eur J Pediatr 140:253–259Google Scholar
  11. 11.
    Parras F, Bouza E, Romero J, Buzon L, Quero M, Brito J, Vellibre D (1990) Infectious endocarditis in children.Pediatr Cardiol 11:77–81Google Scholar
  12. 12.
    Pesanti EL, Smith IM (1979) Infective endocarditis with negative blood cultures: an analysis of 52 cases.Am J Med 66:43–50Google Scholar
  13. 13.
    Roberts GD, Horstmeier C, Hall M (1975) Recovery of yeast from vented blood culture bottles.J Clin Microbiol 2:18–20Google Scholar
  14. 14.
    Roberts RB, Knieger AG, Schiller NL (1979) Viridans streptococci endocarditis: the role of various species include vitamin B6-dependent streptococci.Rev Infect Dis 1:955Google Scholar
  15. 15.
    Schollin J, Bjarke B, Wesstrons G (1985) Infective endocarditis in Swedish children.Acta Paediatr Scand 75:993–1005Google Scholar
  16. 16.
    Skehan JD, Murray M, Mills PG (1988) Infective endocarditis: incidence and mortality in the North East Thames Region.Br Heart J 59:62–68Google Scholar
  17. 17.
    Stafford WS, Petch J, Radford DJ (1985) Vegetations in infective endocarditis: clinical relevance and diagnosis by cross sectional echocardiography.Br Heart J 53:310–313Google Scholar
  18. 18.
    Stanton BF, Baltimore RS, Clemens JD (1984) Changing spectrum of infective endocarditis in children: analysis of 26 cases, 1970–1979.Am J Dis Child 138:720–725Google Scholar
  19. 19.
    The JATS Research Committee (1992) Report of the JATS Research Committee on operated cases in 1990 (in Japanese).JJATS 40:341–346Google Scholar
  20. 20.
    Van Hare FG, Ben-Shachar G, Liebman J, Boxerbaum B, Reimenschneider TA (1984) Infective endocarditis in infants and children during the past 10 years: a decade of change.Am Heart J 107:1235–1240Google Scholar
  21. 21.
    Walterspiel JN, Kaplan SL (1986) Incidence and clinical characteristics of “culture-negative” infective carditis in a pediatric population.Pediatr Infect Dis 5:328–332Google Scholar

Copyright information

© Springer-Verlag New York Inc 1994

Authors and Affiliations

  • J. Fukushige
    • 1
  • H. Igarashi
    • 1
  • K. Ueda
    • 1
  1. 1.Department of Pediatrics, Faculty of MedicineKyushu UniversityFukuokaJapan

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