- 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.
Dr Gaurav Agrawal is a Pediatric Cardiologist (Child and Fetal heart Specialist). Dr Agrawal is a pediatrician who has specialized training in the treatment of various child heart related problems (neonates to 18 years of age). He is also having a vast experience in fetal echocardiography.
He is one of the very few pediatricians in India who practices pediatric cardiology exclusively. Cardiac problems in children are common in children, sometimes life threating and often not diagnosed properly. Early diagnosis and timely treatment is very important. Areas of specific interest include child echocardiography including fetal echocardiography, diagnostic and therapeutic cardiac catheterization (pediatric cardiac holes closure by device, opening of obstructed cardiac valves by balloons etc).
