BACTERIAL ENDOCARDITIS IN CONGENTIAL HEART DISEASE

The prevalance and sequelae of infectious sinusitis in a hospitalized group of children with and without congenital heart disease (CHD) were studied. Sinusitis was more common (1% versus 0.3%) in the CHD group and occurred predominantly (90%) in the cyanotic patients. It was associated with subacute bacterial endocarditis in 20% (5 of 20) and brain abscess in 15% (3 of 20) of the CHD cases. It is postulated that proliferation and distension of the venous channels and marrow spaces in patients with cyanotic CHD enhances the hematogenous spread of bacteria from the paranasal sinuses.

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THERAPEUTIC PRINCIPLES FOR STREPTOCOCCUS VIRIDANS INFECTIONS: RECURRENT BACTERIAL ENDOCARDITIS IN A CHILD WITH CONGENITAL HEART DISEASE

PEDIATRICS ◽

10.1542/peds.35.4.704 ◽

1965 ◽

Vol 35 (4) ◽

pp. 704-708

Author(s):

Welton M. Gersony ◽

Alexander S. Nadas

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

Congenital Heart ◽

Bacterial Endocarditis ◽

Intravenous Therapy ◽

Phenoxymethyl Penicillin ◽

Serum Bactericidal Activity ◽

Therapeutic Principles ◽

Penicillin Therapy ◽

Principles Of Treatment

A case of recurrent bacterial endocarditis due to a relatively resistant alpha streptococcus is reviewed. The following general principles of treatment are recommended: 1. Intravenous penicillin therapy should be instituted in all instances. 2. Should serum bactericidal levels indicate the organism to be extremely sensitive (< 0.1 units/ml) oral phenoxymethyl penicillin (Penicillin-V) may be substituted after 3 weeks. 3. In cases infected with organisms sensitive to greater than 0.1 units/ml, intravenous therapy should be continued for 6 weeks and streptomycin added for 2 weeks. 4. When facilities for studying penicillin sensitivity and serum bactericidal activity are not available, the intravenous penicillin-streptomycin regime is recommended.

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Common Clinical Cardiological Problems: The Absence of Arbitrary Answers

PEDIATRICS ◽

10.1542/peds.52.4.620 ◽

1973 ◽

Vol 52 (4) ◽

pp. 620-620

Author(s):

Walter Silver ◽

Howard A. Joos

Keyword(s):

Heart Failure ◽

Congestive Heart Failure ◽

Heart Disease ◽

Family Physicians ◽

House Staff ◽

Electrolyte Imbalance ◽

Clinical Pediatric ◽

Congential Heart Disease ◽

Electrocardiographic Changes ◽

Cardiac Enlargement

Certain common clinical pediatric cardiologic problems are encountered daily by pediatricians, family physicians, and house staff who may, in the absence of specific guidance, unwittingly commit therapeutic and/or diagnostic misjudgements. Recommendations from the Academy would be most helpful if they can be developed. Such problems include (1) the use of oxygen in infants in congestive heart failure (CHF) secondary to left to right shunting, (2) treatment for "physiologic" anemia (2 to 6 months of age) in the presence of CHF, (3) the use of digoxin in the treatment of patients with cardiac enlargement associated with congential heart disease (CHD) but without overt evidence of CHF, and (4) electrocardiographic changes associated with acidosis and electrolyte imbalance.

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