Hostname: page-component-586b7cd67f-dlnhk Total loading time: 0 Render date: 2024-11-24T09:16:51.290Z Has data issue: false hasContentIssue false
  • English
  • Français

Infectious endocarditis—an experience spanning three decades

Published online by Cambridge University Press:  19 August 2008

James R. Zuberbuhler ,
William H. Neches  and
Sang C. Park
James R. Zuberbuhler*
Affiliation:
From the Division of Cardiology, Children Hospital of Pittsburgh, University of Pittsburgh School of Meclicine, Pittsburgh
William H. Neches
Affiliation:
From the Division of Cardiology, Children Hospital of Pittsburgh, University of Pittsburgh School of Meclicine, Pittsburgh
Sang C. Park
Affiliation:
From the Division of Cardiology, Children Hospital of Pittsburgh, University of Pittsburgh School of Meclicine, Pittsburgh
*
Dr.James R. Zuberbuhler, Division of Cardiology, Children's Hospital of Pittsburgh, One Children's Place, 3705 Fifth Avenue at DeSoto Street, Pittsburgh, PA 15213, USA.
Get access Rights & Permissions [Opens in a new window]

Summer

Over the last 30 years, 94 episodes of infectious endocarditis have been identified in 86 children seen at the Children's Hospital of Pittsburgh. In most of these children no precipitating event could be documented. There was no change in underlying cardiac anomalies over the three decades of this study, and left ventricular outflow tract obstruction, ventricular septal defect and tetralogy of Fallot were the most common anomalies. Streptococci and staphylococci were the most common infecting organisms, and there was a slight increase in the percentage of streptococci in the last decade. Cardiovascular damage occurred in about one-third of the cases, and aortic regurgitation was most common. Mitral regurgitation was also an important complication, as was the development of an aortic aneurysm. Important systemic and pulmonary emboli were rare. Surgical intervention was necessary in one-fifth of the children. Valvar replacement was the most common procedure done. The mortality rate declined markedly over the period of the study, dropping from 36% in the first decade to 8% in the last.

Keywords

Bacterial endocarditiscongenital cardiac malformationsvalvar disease
Type
Original Articles
Information
Cardiology in the Young , Volume 4 , Issue 3 , July 1994 , pp. 244 - 251
Copyright
Copyright © Cambridge University Press 1994

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Johnson, DH, Rosenthal, A, Nadas, AS.A forty-year review of bacterial endocarditis in infancy and childhood. Circulation 1975; 51: 581–588.Google Scholar
VanHare, GF, Ben-Shachar, G, Liebman, J, Boxerbaum, B, Riernenschneider, TA.Infective endocarditis in infants and children during the past 10 years: A decade of change. Am Heart J 1984; 107: 1235–1240.Google Scholar
Parras, F, Bouza, E, Romero, J, Buzón, , Quero, M, Brito, J, Vellibre, D.Infectious endocarditis in children. Pediatr Cardiol 1990; 11: 77–81.Google Scholar
MacMahon, SW, Hickey, AJ, Wilcken, EL, Wittes, JT, Feneley, MP, Hickie, JB.Risk of infective endocarditis in mitral valveprolapse with and without precordial systolic murmurs. Am J Cardiol 1986; 58: 105–109.Google Scholar
Awadallah, SM, Kavey, REW, Byrum, CJ, Smith, FC, Kveselis, DA, Blackman, MS.The changing pattern of infective endocarditis in childhood. Am J Cardiol 1991; 68: 90–94.Google Scholar
Sanabria, TJ, Alpert, JS, Goldberg, R, Pape, LA, Cheeseman, SH.Increasing frequency of staphylococcal infective endocarditis. Arch Intern Med 1990; 150: 1305–1309.Google Scholar
Van der Meer, JTM, Van Wijk, W, Thompson, J, Vanderbroucke, JP, Valkenburg, HA, Michel, MF.Efficacy of antibiotic prophylaxis for prevention of native-valve endocarditis. Lancet 1992; 339: 135–139.Google Scholar
Karl, T, Wensley, D, Stark, J, deLeval, M, Rees, P, Taylor, JFN.Infective endocarditis in children with congenital heart disease: comparison of selected features in patients with surgical correction or palliation and those without. Br Heart J 1987; 58: 57–65.CrossRefGoogle ScholarPubMed
Guntheroth, WG.How important are dental procedures as a cause of infective endocarditis? Am J Cardiol 1984; 54: 797–801.CrossRefGoogle ScholarPubMed
Sholler, GF, Hawker, RE, Celermajer, JM.Infective endocarditis in childhood. Pediatr Cardiol 1986; 6: 183–186.Google Scholar
Schollin, J, Bjarke, B, Wesstrom, G.Infective endocarditis in Swedish children. Location, major complications, laboratory findings, delay of treatment, treatment and outcome. Acta Paediatr Scand 1986; 75: 999–1004.Google Scholar
Moy, RJD, George, RH, deGiovanni, JV, Silove, ED.Improving survival in bacterial endocarditis. Arch Dis Child 1986; 61: 394–399.Google Scholar
Schollin, J, Bjarke, B, Wesstrom, G.Infective endocarditis in Swedish children. Incidence, etiology, underlying factors and port of entry of infection. Acta Paediatr Scand 1986; 75: 995–998.Google Scholar
Gersony, WM, Hayes, CJ.Bacterial endocarditis in patients with pulmonary stenosis, aortic stenosis and ventricular septal defect. Circulation 1977; 56(yes): 184–187.Google Scholar
Jaffe, WM, Morgan, DE, Peariman, AS, Otto, CM.Infective endocarditis, 1983–1988: Echocardiographic findings and factors influencing morbidity and mortality. J Am Coll Cardiol 1990; 15: 1227–1233.Google Scholar
Bricker, JT, Latson, LA, Huhta, JC, Gutgesell, HP.Echocar diographic evaluation of infective endocarditis in children. Clin Pediatr 1985; 24: 312–317.Google Scholar
Ellis, SG, Goldstein, J, Popp, RL.Detection of endocarditis associated paravalvular abscesses by two-dimensional echocardiography. J Am Coil Cardiol 1985; 5: 647–653.Google Scholar
Mügge, A, Daniel, WG, Frank, G, Lichtlen, PR.Echocardi ography in infective endocarditis; reassessment of prognostic implications of vegetation size determined by the transtho racic and the transesophageal approach. J Am Coll Cardiol 1989: 14: 631–638.Google Scholar
Pedersen, WR, Walker, M, Olson, JD, Gobel, F, Lange, HW, Daniel, JA, Rogers, J, Longe, T, Kane, M, Mooney, MR, Goldenberg, IF.Value oftransesophageal echocardiography as an adjunct to transthoracic echocardiography in evaluation of native and prosthetic valve endocarditis. Chest 1991; 100: 351–356.Google Scholar
Erbel, R, Rohmann, S, Drexler, M, Mohr-Kahaly, S, Gerharz, CD, Iversen, S.Improved diagnosticvalue of echocardiography in patients with infective endocarditis by transesophageal approach. Eur Heart J 1988; 9:43–53.Google Scholar
Elward, K, Hruby, N, Christy, C.Pneumococcal endocarditis in infants and children: report of a case and review of the literature. Pediatric Infect Dis J 1990; 9: 652–657.Google Scholar