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Pneumococcal endocarditis in children.

Laurence B Givner1, Edward O Mason, Tina Q Tan

  • 1Department of Pediatrics, Wake Forest University School of Medicine, Winston-Salem, North Carolina 27157, USA. lgivner@wfubmc.edu

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|May 6, 2004
PubMed
Summary
This summary is machine-generated.

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Streptococcus pneumoniae endocarditis is rare in children but frequently leads to severe complications. Most affected children had underlying heart conditions, highlighting the need for vigilance in this population.

Area of Science:

  • Pediatric Infectious Diseases
  • Cardiology
  • Vaccinology

Background:

  • Endocarditis caused by Streptococcus pneumoniae is uncommon in pediatric populations, representing 3%-7% of childhood endocarditis cases.
  • Invasive pneumococcal disease surveillance in children is crucial for understanding disease epidemiology and impact.

Purpose of the Study:

  • To describe the clinical characteristics, complications, and outcomes of children diagnosed with Streptococcus pneumoniae endocarditis.
  • To assess the serotype distribution of pneumococcal isolates in pediatric endocarditis cases and its relation to vaccination.

Main Methods:

  • Prospective surveillance of invasive pneumococcal disease at 8 US children's hospitals from September 1993 to February 2003.
  • Clinical data collection on demographics, predisposing conditions, concomitant infections, treatment, and outcomes for children with pneumococcal endocarditis.

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Main Results:

  • Eleven cases of pediatric pneumococcal endocarditis were identified.
  • The majority of affected children were young (3-36 months), male, and had pre-existing structural heart disease, often with prior cardiac surgery.
  • Significant complications occurred in 45% of patients, including meningitis, and one patient (9%) died. Most isolates were vaccine serotypes.

Conclusions:

  • Pediatric endocarditis due to Streptococcus pneumoniae, though rare, is associated with substantial morbidity and mortality.
  • The high prevalence of pre-existing heart disease underscores the importance of early diagnosis and management.
  • The presence of vaccine serotypes suggests potential for prevention through pneumococcal vaccination.