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Forty year review of bacterial endocarditis in infants and children
Insights
This study reviewed 25 pediatric bacterial endocarditis cases from 1950-1989. Congenital heart disease was common, and Streptococcus viridans was the primary pathogen, though its incidence declined over time.
Area of Science:
- Pediatrics
- Infectious Diseases
- Cardiology
Background:
- Bacterial endocarditis is a serious infection affecting heart valves.
- Congenital heart disease (CHD) is a significant risk factor for endocarditis.
- Understanding trends in pediatric endocarditis is crucial for effective management.
Purpose of the Study:
- To analyze the clinical characteristics and outcomes of bacterial endocarditis in children treated at Tokyo University.
- To identify trends in causative organisms and associated conditions over a 40-year period.
Main Methods:
- Retrospective review of 25 pediatric patients treated for bacterial endocarditis between 1950 and 1989.
- Analysis of patient demographics, underlying conditions (especially congenital heart disease), blood culture results, and treatment outcomes.
- Examination of trends in pathogen incidence and mortality.
Main Results:
- Twenty-two of 25 patients had pre-existing congenital heart disease.
- Positive blood cultures were found in 21 patients, with Streptococcus viridans being the most frequent isolate.
- The incidence of Streptococcus viridans infections decreased in the latter 20 years of the study period.
- Only a few post-surgical cases with CHD were noted.
- Three deaths occurred, all before 1965.
Conclusions:
- Congenital heart disease is a predominant comorbidity in pediatric bacterial endocarditis.
- Streptococcus viridans remains a key pathogen, but its prevalence may be decreasing.
- Improved diagnostics and treatment have likely contributed to reduced mortality over time.
Abstract:
From 1950 through 1989 at Tokyo University's Department of Pediatrics, 25 children were treated for bacterial endocarditis. Twenty-two of these patients had previously been diagnosed as suffering from congenital heart disease. Twenty one of the 25 patients had positive blood cultures. Streptococcus viridans was the most common organism isolated, although the incidence of Streptococcus viridans infection has decreased in the last 20 years. In present series only a few post-surgical cases with congenital heart disease occurred. There were three deaths which all occurred prior to 1965.