Endocarditis is the inflammation of the inner lining of the heart valves and chambers, caused by a bacterial infection or, rarely, by viruses or fungi.
The initial infection occurs after manipulation at the dentist, through a wound or as a result of skin, soft tissue or bone surgery. The germs get into the blood and nest in valves or heart chambers, most of which are already defective and more fragile.
Symptoms may occur rapidly (fever and rapid heart rate, fatigue) or slowly (mild fever, weight loss, excessive sweating, anemia and freckle-like skin spots on the palms of the hands, nails, soles of the feet and whites of the eyes).
Diagnosis is made by a detailed clinical history, physical examination, electrocardiogram, blood tests with cultures, chest X-ray and echocardiogram (Duke criteria).
Treatment is based on intravenous antibiotics and medical treatment of symptoms. More severe cases may require surgery.
- Sharon E O'Brien, MD. Infective endocarditis in children. UpToDate. Nov 02, 2015.
- Marom D, Levy I, Gutwein O, et al. Healthcare-associated versus community-associated infective endocarditis in children. Pediatr Infect Dis J 2011; 30:585.
- Penk JS, Webb CL, Shulman ST, Anderson EJ. Echocardiography in pediatric infective endocarditis. Pediatr Infect Dis J 2011; 30:1109.
- Nishimura RA, Otto CM, Bonow RO, et al. 2014 AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 2014; 63:e57.
