Infective endocarditis in thirteen children: a retrospective study (1974-1981).

Thirteen children (11 African, two Indian) with infective endocarditis are described. Rheumatic heart disease was present in nine of the children and was therefore a major determinant of infective endocarditis whereas a congenital cardiac abnormality (Fallot's tetralogy) was detected in only one child. Staphylococcus aureus was the commonest infecting organism, being found in five children, and Streptococcus viridans was isolated in one. Fever, murmurs and anaemia were the most frequent clinical expression of the disease. Renal problems were trivial except in two children with endocarditis due to Staphylococcus aureus in whom they were serious. Staphylococcus aureus endocarditis was uniformly fatal. Among eight children who died neurological complications caused death in four. The patterns of infective endocarditis in developed and Third-World countries are compared.