Mecrow I K, Ladusans E J
St Mary's Hospital, Manchester, UK.
Acta Paediatr. 1994 Jan;83(1):35-9. doi: 10.1111/j.1651-2227.1994.tb12949.x.
Twelve infants with structurally normal hearts were demonstrated to have intracardiac vegetations on echocardiography and diagnosed as having infective endocarditis. All were found in the right side of the heart, most frequently at the junction of the superior vena cava and the right atrium and in no case involved the tricuspid or pulmonary valves. Most were diagnosed in the course of investigation of repeatedly positive blood cultures, despite appropriate antibiotic therapy. Coagulase-negative staphylococci were isolated from blood culture in nine infants, and Streptococcus sanguis and Candida albicans from one each. All infants had had intracardiac central lines inserted to facilitate venous access, either by a percutaneous technique or as a formal surgical procedure. Eight (67%) were successfully treated and made a full recovery. Cardiac murmurs were absent in all of the cases. Echocardiography should be included in the investigation of all neonates with persistently positive blood culture, particularly when intracardiac lines have been sited. Right-sided, non-valvar lesions and infection with coagulase-negative staphylococci may carry a better prognosis than previously reported.
12名心脏结构正常的婴儿经超声心动图检查显示有心内赘生物，并被诊断为感染性心内膜炎。所有赘生物均位于心脏右侧，最常见于上腔静脉与右心房交界处，无一例累及三尖瓣或肺动脉瓣。尽管进行了适当的抗生素治疗，但大多数患儿是在反复血培养阳性的调查过程中被诊断出来的。9名婴儿血培养分离出凝固酶阴性葡萄球菌，1名婴儿分离出血链球菌，1名婴儿分离出白色念珠菌。所有婴儿均通过经皮技术或正式外科手术插入了心内中心静脉导管以方便静脉通路。8名（67%）患儿成功治愈并完全康复。所有病例均无心脏杂音。对于所有血培养持续阳性的新生儿，尤其是已放置心内导管的新生儿，应进行超声心动图检查。右侧非瓣膜性病变以及凝固酶阴性葡萄球菌感染的预后可能比先前报道的要好。
