- 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
- 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.