Changing spectrum of infective endocarditis in children. Analysis of 26 cases, 1970-1979
B. F. Stanton, R. S. Baltimore and J. D. Clemens
The decade of the 1970s was marked by an increased survival of children
with complex heart lesions, use of prosthetic material in open heart
surgery, and placement of indwelling central catheters in critically ill
patients. We analyzed all 26 cases of children with infective endocarditis
(IE) seen at Yale University, New Haven, Conn, from 1970 through 1979 to
determine whether these and other factors resulted in a change in pediatric
IE. A larger proportion of cases arose postoperatively as compared with
previous series. Among the postsurgical and catheterization-related cases,
the most common infecting agents were streptococci, not the expected
staphylococci. Although the number of cases was small, IE associated with
prosthetic material had a favorable prognosis; all survivors of IE with
prosthetic material were cured by medical regimens alone. The IE cases in
children with previously normal hearts were associated with indwelling
central catheters.
