Circulation, Vol 51, 581-588, Copyright © 1975 by American Heart Association
DH Johnson, A Rosenthal and AS Nadas
A retrospective review of 149 episodes of bacterial endocarditis (BE) in
141 patients under 25 years of age, at The Children's Hospital Medical
Center from 1933 through June of 1972, demonstrates increasing survival and
a distinct change in the frequency of underlying congenital heart disease
and rheumatic heart disease (RHD). Certain forms of congenital heart
disease such as tetralogy of Fallot, small ventricular septal defect, and
aortic stenosis are at particular risk for BE. Following BE, patients with
ventricular septal defect and tetralogy of Fallot have less morbidity and
higher survival rates than children with aortic outflow lesions. over the
entire time period, alpha Streptococcus is the most common pathogen and
Staphylococcus aureus, second most frequent organism. Surgical correction
in patients with congenital heart disease may offer the best form of
prevention.
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A forty-year review of bacterial endocarditis in infancy and childhood
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