infective endocarditis in children

a total of 14 cases of infective endocarditis (ie) in children aged 6 months to 10 years were seen from december 1987 to december 1992 at the pediatric unit of ayatollah taleghani medical center. the majority of patients (12 of 14) were between 5 and 10 years of age. acyanotic congenital heart disease was known to preexist in 78.6% and rheumatic valvular heart disease in 21.4% of cases. organisms were identified by blood culture in 50%, the majority being streptococcus viridalls (36% of cases). vegetations were detected by echocardiography in 64%. the overall death rate was 21.4%. two patients with aortic stenosis developed ie after cardiac surgery for repair of stenotic valves and both of them died. one patient with rheumatic aortic and mitral valve insufficiency underwent valve replacement due to intractable heart failure. in conclusion, the frequent presence of underlying heart disease, the rarity of ie in infancy, and the ominous prognosis of postoperative endocarditis and aortic valve involvement are emphasized.