Related Experiment Videos
Insights
Pediatric infective endocarditis is rare but serious in children with congenital heart disease. Staphylococcus aureus infections and young age significantly increase mortality risk, necessitating prompt investigation and treatment.
Area of Science:
- Pediatric Cardiology
- Infectious Diseases
- Cardiovascular Surgery
Background:
- Infective endocarditis (IE) is uncommon in the general pediatric population.
- Children with congenital heart disease (CHD) face a significant lifelong risk of IE.
- Advances in CHD management increase long-term survival, potentially raising the number of children at risk for IE.
Purpose of the Study:
- To review the clinical characteristics, treatment, and outcomes of pediatric infective endocarditis.
- To identify risk factors and common pathogens associated with IE in children.
- To emphasize the importance of early diagnosis and aggressive management in high-risk pediatric populations.
Main Methods:
- Retrospective review of 50 pediatric endocarditis cases diagnosed at the Mayo Clinic between 1950 and 1979.
- Analysis of patient demographics, underlying cardiac conditions, causative organisms, and treatment outcomes.
- Correlation of mortality with age, cardiac status, and specific pathogens.
Main Results:
- 37 out of 50 patients had underlying congenital heart disease.
- Staphylococcus aureus was the most common pathogen (19 cases), followed by viridans streptococci (14 cases).
- Mortality was higher in children younger than 10 years and in those with S. aureus infections (19 deaths overall).
Conclusions:
- Unexplained fever in children with CHD warrants thorough investigation for endocarditis.
- Early empiric antibiotic therapy is crucial upon suspicion of endocarditis.
- Aggressive treatment of localized bacterial infections in at-risk children is vital to prevent cardiac complications.
Abstract:
Infective endocarditis is a rare disease in the general pediatric population. Nonetheless, children with congenital heart disease have a substantial lifetime risk for development of endocarditis, and recent advances in the management of these children should increase the number of patients who survive infancy and early childhood. During the 30-year period from 1950 through 1979, 50 cases of endocarditis in children were diagnosed at the Mayo Clinic. Of these 50 patients, 37 had congenital heart disease, and 8 were diagnosed as having endocarditis within 3 months after having undergone a cardiac surgical procedure. Nineteen patients died of the disease or its complications. The most common organism isolated at Staphylococcus aureus (19 patients), followed by viridans streptococci (14 patients). Children younger than 10 years of age experienced a particularly high mortality, as did patients of all ages with S. aureus infection. Any unexplained fever in a child with congenital heart disease deserves close investigation; if endocarditis is suspected, early empiric antibiotic therapy is indicated after appropriate culture specimens have been obtained. Moreover, localized bacterial infections in children at risk must be treated aggressively to prevent metastatic spread to the heart.