Pediatric Cardiology

, Volume 6, Issue 4, pp 183–186 | Cite as

Infective endocarditis in childhood

  • Gary F. Sholler
  • Richard E. Hawker
  • John M. Celermajer
Original Articles


A total of 37 cases of infective endocarditis, in children aged two days to 13 years, were seen from 1971 to 1983 at the Children's Hospital, Camperdown. Structural heart disease was known to preexist in 95%. Cyanotic congenital heart disease was present in 15 children, of whom 11 had been palliated by a systemic-to-pulmonary artery shunt. In five children, there was infection of a prosthetic valve. Identifiable precipitants of infection were rare. In particular, no child had had a preceding dental procedure within three months, while only 19% had had recent cardiac surgery.

Organisms were identified by blood culture in 92%, the majority being streptococci (43% of cases) and staphylococci (27% of cases). While 59% of all organisms were penicillin sensitive, six of the seven early postoperative children were infected with organisms not sensitive to antibiotics, given for wound infection prophylaxis in the perioperative period.

The overall death rate was 13.5%. Of the children infected withStaphylococcus aureus, 40% died, while no child withStreptococcus viridans endocarditis died. Of the survivors, four needed urgent valve replacement, and three had major central nervous system complications.

Using these figures, a current profile of patients with infective endocarditis is presented.

Key words

Childhood Infective endocarditis Congenital heart disease Valvar heart disease 


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  1. 1.
    Bayliss R, Clarke C, Oakley CM (1983) The teeth and infective endocarditis.Br Heart J 50:506–512PubMedGoogle Scholar
  2. 2.
    Bayliss R, Clarke C, Oakley CM, et al. (1983) The microbiology and pathogenesis of infective endocarditis.Br Heart J 50:513–519PubMedGoogle Scholar
  3. 3.
    Brooks SL (1980) Survey of compliance with American Heart Association guidelines for prevention of bacterial endocarditis.JADA 101:41–43PubMedGoogle Scholar
  4. 4.
    Finland M (1973) Current problems in infective endocarditis with special reference to cases acquired in hospital or after cardiac surgery.Mod Concepts Cardiovasc Dis 41:53–58Google Scholar
  5. 5.
    Hashaway T, Stone LJ (1982) Antibiotic prophylaxis of sub-acute bacterial endocarditis for adult patients by dentists in Dade County, Florida.Circulation 66:1110–1113Google Scholar
  6. 6.
    Haywood GW (1973) Infective endocarditis: a changing disease.Br Med J 2:706Google Scholar
  7. 7.
    Hess J, Holloway Y, Dankert J (1983) Incidence of postextraction bacteremia under penicillin cover in children with cardiac disease.Pediatrics 71:554–558PubMedGoogle Scholar
  8. 8.
    Johnson CM, Rhodes KH (1982) Pediatric endocarditis.Mayo Clin Proc 57:86–94PubMedGoogle Scholar
  9. 9.
    Johnson DH, Rosenthal A, Nadas A (1975) A forty year review of bacterial endocarditis in infancy and childhood.Circulation 51:581–588PubMedGoogle Scholar
  10. 10.
    Johnson DH, Rosenthal A, Nadas A (1975) Bacterial endocarditis in children under 2 years of age.Am J Dis Child 129:183–186PubMedGoogle Scholar
  11. 11.
    Kaplan, EL, Rich H, Gersony W, et al. (1979) A collaborative study of infective endocarditis in the 1970s.Circulation 59:327–335PubMedGoogle Scholar
  12. 12.
    Lissauer T, De Vere-Tyndall A (1983) Rheumatic fever.Update (April 1):1197–1209Google Scholar
  13. 13.
    McGowan DA, Toshy O (1968) Dental treatment of patients with valvular heart disease.Br Dent J 124:519–520PubMedGoogle Scholar
  14. 14.
    Oakley CM, Darrell JH (1980) Antibiotic prophylaxis for bacterial endocarditis.Am J Cardiol 46:1073CrossRefPubMedGoogle Scholar
  15. 15.
    Saravolatz LP, Burek KH, Quinn EL, et al. (1978) Polymicrobial infective endocarditis: an increasing clinical entity.Am Heart J 95:163–71CrossRefPubMedGoogle Scholar
  16. 16.
    Watts J McK, McDonald PJ, O'Brien PE, et al. (1981)Infection in surgery: basic and clinical aspects. Churchill Livingstone, EdinburghGoogle Scholar
  17. 17.
    Weinstein L, Schlesinger J (1973) Treatment of infective endocarditis—1973.Prog Cardiovasc Dis 16:275–296PubMedGoogle Scholar
  18. 18.
    Zakrzewski T, Keith JD (1965) Bacterial endocarditis in infants and children.J Pediatr 67:1179–1193Google Scholar

Copyright information

© Springer-Verlag New York Inc 1986

Authors and Affiliations

  • Gary F. Sholler
    • 1
  • Richard E. Hawker
    • 1
  • John M. Celermajer
    • 1
  1. 1.Adolph Basser Institute of CardiologyChildren's HospitalCamperdownAustralia

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