The inner lining of the heart chambers and heart valves is called the endocardium. Endocarditis occurs when this tissue becomes swollen or inflamed, most often due to infection at the heart valves.
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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 an underlying condition such as:
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 may 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:
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:
Call your child's 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.
Kaplan SL, Vallejo JG. Infective endocarditis. In: Cherry JD, Harrison GJ, Kaplan SL, Steinbach WJ, Hotez PJ, eds. Feigin and Cherry's Textbook of Pediatric Infectious Diseases. 8th ed. Philadelphia, PA: Elsevier; 2019:chap 26.
Marcdante KJ, Kliegman RM, Schuh AM. Infective endocarditis. In: Marcdante KJ, Kliegman RM, Schuch AM, eds. Nelson Essentials of Pediatrics. 9th ed. Philadelphia, PA: Elsevier; 2023:chap 111.
Mick NW. Pediatric fever. In: Walls RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 161.
Review Date:
5/8/2022 Reviewed By: Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. |