Endocarditis - children


Definition

The inner lining of the heart chambers and heart valves is called the endocardium. Endocarditis occurs when this tissue becomes swollen or inflamed.

Alternative Names

Valve infection - children; Staphylococcus aureus - endocarditis - children; Enterococcus - endocarditis- children; Streptococcus viridians - endocarditis - children; Candida - endocarditis - children; Bacterial endocarditis - children; Infective endocarditis - children; Congenital heart disease - endocarditis - children

Causes

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Endocarditis occurs when germs enter the bloodstream and then travel to the heart.

Endocarditis can involve the heart muscle, heart valves, or lining of the heart. Children with endocarditis may have a:

The risk is higher in children who have a history of heart surgery, which can leave rough areas in the lining of the heart chambers.

This makes it easier for bacteria to stick to the lining.

Germs are most likely to enter the bloodstream:

Symptoms

Symptoms of endocarditis may develop slowly or suddenly.

Fever, chills, and sweating are frequent symptoms. These sometimes can:

Other symptoms may include:

Neurological problems, such as seizures and, disturbed mental status

Signs of endocarditis can also include:

Exams and Tests

Your child's health care provider may perform transthoracic echocardiography (TTE) to check for endocarditis in children age 10 years or younger.

Other tests may include:

Treatment

Treatment for endocarditis depends upon the:

Your child will need to be in the hospital to receive antibiotics through a vein (IV). Blood cultures and tests will help the provider choose the best antibiotic.

Your child will need long-term antibiotic therapy.

Surgery to replace an infected heart valve may be needed when:

Outlook (Prognosis)

Getting treatment for endocarditis right away improves the chances of clearing the infection and preventing complications.

Possible Complications

The possible complications of endocarditis in children are:

When to Contact a Medical Professional

Call your child's health care provider if you notice the following symptoms during or after treatment:

Prevention

The American Heart Association recommends preventive antibiotics for children at risk for endocarditis, such as those with:

These children should receive antibiotics when they have:

References

Baltimore RS, Gewitz M, Baddour LM, et al; American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee of the Council on Cardiovascular Disease in the Young and the Council on Cardiovascular and Stroke Nursing. Infective endocarditis in childhood: 2015 update: a scientific statement from the American Heart Association. Circulation. 2015;132(15):1487-1515. PMID: 26373317 www.ncbi.nlm.nih.gov/pubmed/26373317.

Marcdante KJ, Kliegman RM. Infective endocarditis. In: Marcdante KJ, Kliegman RM, eds. Nelson Essentials of Pediatrics. 7th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 111.

Starke JR. Infective endocarditis. In: Cherry JD, Harrison GJ, Kaplan SL, Steinbach WJ, Hotez PJ, eds. Feigin and Cherry's Textbook of Pediatric Infectious Diseases. 7th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 26.

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