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

D H Johnson, A Rosenthal, A S Nadas

    Circulation
    |April 1, 1975
    PubMed

    Insights

    Bacterial endocarditis (BE) survival has improved in young patients, with congenital heart disease posing the highest risk. Surgical correction of congenital heart disease may be the best prevention strategy.

    Area of Science:

    • Pediatric Cardiology
    • Infectious Diseases
    • Cardiovascular Surgery

    Background:

    • Bacterial endocarditis (BE) is a serious infection affecting heart valves.
    • Congenital heart disease (CHD) and rheumatic heart disease (RHD) are significant risk factors for BE.
    • Understanding trends in BE is crucial for pediatric patient management.

    Purpose of the Study:

    • To analyze trends in bacterial endocarditis (BE) in patients under 25 years of age.
    • To identify specific congenital heart conditions associated with increased BE risk.
    • To evaluate survival rates and outcomes following BE in relation to underlying heart conditions.

    Main Methods:

    • Retrospective review of 149 BE episodes in 141 pediatric patients (1933-1972).
    • Analysis of patient demographics, underlying cardiac conditions, pathogens, and outcomes.
    • Comparison of outcomes based on specific congenital heart defects.

    Main Results:

    • Increasing survival rates for bacterial endocarditis (BE) observed over the study period.
    • Tetralogy of Fallot, small ventricular septal defect, and aortic stenosis identified as high-risk congenital heart conditions for BE.
    • Patients with ventricular septal defect and tetralogy of Fallot showed better outcomes post-BE compared to those with aortic outflow lesions.
    • Alpha Streptococcus and Staphylococcus aureus were the most common pathogens identified.

    Conclusions:

    • Surgical correction of congenital heart disease may serve as a primary preventive measure against BE.
    • Specific congenital heart defects confer different risks and prognoses for bacterial endocarditis.
    • Long-term trends indicate improved management and outcomes for pediatric bacterial endocarditis.

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