PEDIATRICS Vol. 71 No. 3 March 1983, pp. 392-397
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Endocarditis in High-Risk Neonates

David G. Oelberg MD1, David J. Fisher MD1, Donald M. Gross MD1, Susan E. Denson MD1, and Eugene W. Adcock III MD1

1 From the Department of Pediatrics, The University of Texas Health Science Center at Houston, Medical School, Houston

The clinical spectrum of neonatal endocarditis, including bacterial and nonbactenal types, is examined in five case reports that were drawn from nursery experiences over a recent 2-year period. In contrast to previous reports of 100% mortality from neonatal endocarditis, one patient survived. Changing heart murmur and hematuria were most frequently associated with bacterial and nonbacterial endocarditis in four of the five cases. Pulmonary hypertension, thrombocytopenia, and coagulopathy were also associated with nonbacterial endocarditis. Echocardiograms were performed on four of the patients; only one was suggestive of endocarditis. Staphylococcus aureus was isolated from both cases of bacterial endocarditis, including the single survivor. Thus, it is suggested that the initial antibiotic coverage of any neonate with the clinical syndrome of sepsis, hematuria, and a heart murmur include antistaphylococcal coverage for the possibility of bacterial endocarditis.

Key Words: bacterial endocarditis • nonbacterial endocarditis • echocardiography • neonatal staphylococcal infection

Submitted on April 12, 1982
Accepted on May 24, 1982




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