The occurrence of bacterial endocarditis in association with a congenital cardiac defect is of interest because it is uncommon, because it presents certain diagnostic difficulties, and because of its bearing on the origin of bacterial infection of the endocardium. Its rarity is probably due to the infrequency of congenital heart disease after the first few years of life. According to Libman,1 bacterial endocarditis usually attacks damaged valves or altered endocardial surfaces. Sufferers from congenital cardiac defects are, therefore, probably more prone to develop bacterial endocarditis than are normal persons. In children in whom both congenital and acquired cardiac affections are frequent, it is surprising, as Cautley 2 has pointed out, that bacterial endocarditis is not more common than it is.
Among the 150 cases of bacterial endocarditis included in Horder's 3 series, there were eight cases in which the heart showed congenital lesions. Allbutt4 has reported sixty-four cases
CLARKE NE. BACTERIAL ENDOCARDITIS IN CONGENTIAL HEART DISEASE. JAMA. 1923;81(5):371–375. doi:10.1001/jama.1923.02650050025008
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