Diagnosis of infective endocarditis

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A child with an existing heart problem might get infective endocarditis, which is a severe heart infection.

Key points

  • Infective endocarditis (IE) is caused by germs that get into the blood and stay in the heart.
  • If blood does not flow through your child’s heart or valves smoothly because of heart problems, they are more likely to get infective endocarditis.
  • Treatment for this condition is antibiotics through an IV.
  • Early diagnosis and aggressive intervention allow for generally position outcomes for children who develop infective endocarditis.

Infective endocarditis (IE) is a serious infection of the heart that can cause damage to the heart or death if untreated.

What is infective endocarditis?

Infective endocarditis (IE) is a serious infection of the heart caused by germs that get into the blood and stay in the heart. It was formerly known as bacterial endocarditis or subacute bacterial endocarditis (SBE).

A child with an existing heart problem might get infective endocarditis while having an operation or dental treatment that causes bleeding. Usually, a child’s body can kill the germs, and they do not get sick. But if blood does not flow through your child’s heart or valves smoothly because of heart problems, your child is more likely to get infective endocarditis. It is more likely to occur in children with complex cyanotic defects, shunts, and artificial heart valves.

While the chance of getting this infection is low, knowing how to prevent it is important, since it can be very serious, possibly resulting in damage to the heart or death, if untreated.

What causes infective endocarditis?

Germs get into the bloodstream and lodge inside the heart. The germs can sometimes get into the blood after an operation or dental cleaning that causes bleeding.

What are the signs of infective endocarditis?

  • a slight fever of 37.5°C to 38.5°C that you cannot explain and that lasts for 5 to 7 days
  • sweating
  • loss of appetite
  • pain in the muscles and joints, such as the knees, shoulders, or knuckles
  • loss of weight
  • a skin rash
  • headaches
  • a general feeling of weakness

The signs of infective endocarditis are like the signs of the flu. You may find it hard sometimes to know if your child has infective endocarditis. If your child has some of these signs and they do not go away, have your paediatrician or family doctor check your child.

How does infective endocarditis affect the heart and body?

The germs that get into the heart will grow and cause large pieces of “vegetation” to form. This can damage the part of the heart where the bacteria are growing. Also, these chunks of vegetation can break away from the heart's surface and move into other parts of the body, like the lungs, potentially causing blockage, which can be damaging.

How is infective endocarditis diagnosed?

There are tests that can help the doctors find out if your child has infective endocarditis:

  • blood tests to check for bacteria; your child may need to have several blood samples taken at different times
  • a urine test, which tests your child’s urine for the blood and inflammation that can accompany endocarditis
  • an echocardiogram, which is a recording of the positions and movement of the walls of the heart or the parts inside the heart, such as the valves

How is infective endocarditis treated?

If your child has infective endocarditis, the doctor will give him antibiotics through an IV. Your child may need antibiotics for as long as 6 weeks or more. He may need to stay in the hospital or be treated at home by nurses from a home care service for part of the 6 weeks. For more serious cases, surgery may be needed.

What are the long-term outcomes of infective endocarditis?

With early diagnosis and aggressive intervention, outcomes for children who develop infective endocarditis are generally positive. Left untreated, this infection can be fatal. Preventing it from occurring is the main goal.

More information

For more information, visit Preventing Infective Endocarditis.

Last updated: December 4th 2009