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Clinical Pediatrics
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Bacterial Endocarditis due to Penicillin-Resistant Streptococcus viridans

V.P. McCarthy

Department of Pediatrics, University of Kansas medical Center, College of Health Sciences and Hospital, Kansas City, Kansas

C.T. Cho

Department of Pediatrics, University of Kansas medical Center, College of Health Sciences and Hospital, Kansas City, Kansas

A.M. Diehl

Department of Pediatrics, University of Kansas medical Center, College of Health Sciences and Hospital, Kansas City, Kansas

B.W. Ramsey

Department of Pediatrics, University of Kansas medical Center, College of Health Sciences and Hospital, Kansas City, Kansas

Bacterial endocarditis remains a formidable diagnostic and therapeutic problem for clinicians. Streptococcus viridans still accounts for 45 to 50 per cent of all cases and between 5 to 10 per cent of all clinical isolates of Strepto coccus viridans from patients with bacterial endocarditis may be relatively resistant to penicillin. The case of a 9-year-old child with Tetralogy of Fallot and a Waterston shunt who subsequently developed bacterial endocarditis due to penicillin-resistant Streptococcus viridans following failure of oral peni cillin dental prophylaxis is presented. In the face of penicillin resistance, additional considerations for workup, including microbiological assays for antimicrobial synergism become necessary in the selection of a therapeutic regimen.

Clinical Pediatrics, Vol. 18, No. 5, 263-266 (1979)
DOI: 10.1177/000992287901800501


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