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Bacterial endocarditis in neonatal intensive care.
G F Opie1, S H Fraser, J H Drew
1Department of Paediatrics, Mercy Hospital for Women, Melbourne, Victoria, Australia.
Journal of Paediatrics and Child Health
|January 15, 2000
Summary
Bacterial endocarditis is rare in neonates but serious, with vague symptoms. Early consideration in unwell, very low birthweight infants is crucial for survival.
Area of Science:
- Neonatal Medicine
- Infectious Diseases
- Pediatric Cardiology
Background:
- Bacterial endocarditis (BE) is a rare but serious condition in neonates.
- Clinical presentation in premature infants is often nonspecific, posing diagnostic challenges.
Purpose of the Study:
- To determine the incidence of BE in a level III neonatal nursery.
- To describe clinical features, survival rates, and the role of central venous catheters (CVCs) in neonatal BE.
Main Methods:
- Retrospective review of echocardiographic and clinical records of infants admitted between 1983 and 1995.
- Case-matched control group for comparison.
Main Results:
- An incidence of 0.07% (8/12,249 infants) was observed.
- Common features included prematurity (<32 weeks), low birthweight (<1500g), and altered white blood cell counts.
- Tricuspid valve involvement was frequent, often associated with CVCs, though CVCs were not statistically significant risk factors.
Conclusions:
- BE is uncommon but generally not fatal in neonates.
- Nonspecific signs necessitate considering BE in very low birthweight infants presenting with illness.