BACTERIAL ENDOCARDITIS IN CHILDREN WITH HEART DISEASE A Review Based on the Literature and Experience with 58 Cases

摘要: We have reviewed the literature and our experience with 58 patients bacterial endocarditis superimposed upon pre-existing heart disease, observed during 30-year period, January 1930 through December 1959. There has been no change in relative incidence of children disease at Babies Hospital since introduction antibiotics. Twenty-one (0.49/1,000 admissions) were from 1943 37 (0.52/1,000 1944 In majority (40) infection was a congenital malformation heart, while 17 there evidence rheumatic disease. one, complicated anomaly. The history usually revealed unexplained fever fatigue child known to Additional symptoms often reflected nature underlying cardiac pathology. Patients tetrad Fallot developed secondary hypoxia which some instances later shown be attributable vegetations sites resulting obstruction pulmonary blood flow. pathogenesis is defined terms bacteremia abnormal endocardial or endothelial surfaces; further role hemodynamic trauma acquired lesions discussed. results bacteriologic studies as vital confirming diagnosis planning treatment management meningitis. Blood cultures positive first sample obtained (86%) always by sixth. Bacterial uncommon presence sterile providing an adequate number (six), each sufficient quantity (10 ml), are sufficiently long after antibiotics discontinued they incubated aerobic anaerobic media for 3 weeks. children, most important prognostic features (1) recognition (2) infecting organism, (3) antibiotic treatment. seven correct had not considered prior necropsy examination. Among treated antibiotics, recovery occurred 20 due viridans streptococci, 1 gamma-streptococci, 8 Staphylococcus aureus. principles discussed suggestions outlined therapy endocarditis. Penicillin alone recommended if organisms highly sensitive, whereas coccus aureus combination chloramphenicol, erythromycin penicillin advocated initial therapy. importance use therapeutic dosage prophylaxis dental manipulation other surgical procedures stressed.