Also known as: Valve infection - children, Staphylococcus aureus - endocarditis - children, Enterococcus - endocarditis- children, Streptococcus viridians - endocarditis - children, Candida - endocarditis - children, Bacterial endocarditis - children, Infective endocarditis - children or Congenital heart disease - endocarditis - children
- Bacterial infection is the most common cause
- Fungal infections are much more rare
- In some cases, no germs can be found after testing
- Birth defect of the heart
- Damaged or abnormal heart valve
- New heart valve after surgery
- By way of a central venous access line that is in place
- During dental surgery
- During other surgeries or minor procedures to the airways and lungs, urinary tract, infected skin, or bones and muscles
- Be present for days before any other symptoms appear
- Come and go, or be more noticeable at nighttime
- Joint pain
- Muscle pain
- Trouble breathing
- Weight loss
- Cause of the infection
- Child's age
- Severity of the symptoms
- Your child will need this therapy for 4 to 8 weeks to fully kill all the bacteria from the heart chambers and valves.
- Antibiotic treatments started in the hospital will need to be continued at home once your child is stable.
- Antibiotics don't work to treat the infection
- The infection is breaking off in little pieces, resulting in strokes
- The child develops heart failure as a result of damaged heart valves
- The heart valve is badly damaged
- Damage to the heart and heart valves
- Abscess in the heart muscle
- Infective clot in the coronary arteries
- Stroke, caused by small clots or pieces of the infection breaking off and traveling to the brain
- Spread of the infection to other parts of the body, such as the lungs
- Blood in urine
- Chest pain
- Weight loss without a change in diet
- Certain birth defects of the heart
- Heart transplant and valve problems
- Man-made (prosthetic) heart valves
- A past history of endocarditis
- Dental procedures that are likely to cause bleeding
- Procedures involving the breathing tract, the urinary tract, or the digestive tract
- Procedures on skin infections and soft tissue infections
The inner lining of the heart chambers and heart valves is called the endocardium. Endocarditis occurs when this tissue becomes swollen or inflamed.
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 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 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:
Getting treatment for endocarditis right away improves the chances of clearing the infection and preventing 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:
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:
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.
- Review date:
- December 07, 2016
- Reviewed by:
- Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
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