• Infective endocarditis refers to infection of heart endocardium mainly the valves.
  • It can affect various organs of the body like kidney, brain, spleen, lungs, skin, eyes etc.
  • Usually caused by bacterial infection but can also be infected by fungus and other germs as well.
  • Streptococci or staphylococci are most commonly involved bacteria that infect the heart endocardium.
  • Infective endocarditis can affect any age group. Males are more affected than females.
  • High risk children are those who are having congenital heart disease, damaged heart valves, artificial heart valves etc.
  • Endocarditis needs to be treated aggressively otherwise can destroy heart valves and leads to life threatening condition.
  • Symptoms and signs due to infective endocarditis can be
    • Fever, malaise, easy fatigue, joint pain, shortness of breath, cardiac murmur, bleeding.
    • Septic embolism, hemorrhage in eye, brain; renal or splenic infarcts.
  • Diagnosis: Requires high index of suspicion
    • Blood culture and sensitivity
    • Echocardiograph
    • CT scan
    • Cardiac MRI
    • Clinical criteria: Modified Duke’s criteria are used for diagnosis.
      • Can be suspected in child with a heart murmur who is having fever with no focus of infection.
      • Suspicion should be very high if any of the following is present: blood cultures are positive, recent invasive procedures.

Treatment of IE

  • It is mainly by giving intravenous antibiotics depending on sensitivity of grown bacteria on blood culture.
  • Generally antibiotics are given for 4-6 weeks depending on the bacteria grown on culture.
  • Sometimes, cardiac surgery is advised when valves are severely affected.
  • Removal of source of infection is advised if found.

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