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Endocarditis, Pediatric

Jenifer A. Glatz, MD Reviewed 10/2018
 


BASICS

DESCRIPTION

Infective endocarditis (IE) is a microbial infection of the endocardium of the heart, especially of the heart valves. 

EPIDEMIOLOGY

Incidence

  • IE is relatively uncommon in children, acco...

DIAGNOSIS

HISTORY

  • Signs and symptoms of IE in children are typically nonspecific, so a meticulous history is essential.

  • General symptoms include:

    • Fever, chills, rigors, diaphoresis

    • Malaise, fatigue

    • Anorexi...

TREATMENT

GENERAL MEASURES

  • Rest

  • Optimal nutrition and hydration

  • Careful dental hygiene

MEDICATION

Antibiotics 
  • Prolonged IV therapy (at least 4 weeks and often 6 to 8 weeks) is needed.

  • Choice of antibiotic(s...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Obtain repeat blood cultures after a few days of antibiotic or antifungal therapy to ensure organism eradication.

  • Repeat blood cultures after com...

ADDITIONAL READING

  • Baltimore RS, Gewitz M, Baddour LM, et al. Infective endocarditis in childhood: 2015 update: a scientific statement from the American Heart Association. Circulation.  2015;132(...

CODES

ICD9

  • 424.9 Endocarditis, valve unspecified, unspecified cause

  • 421 Acute and subacute bacterial endocarditis

  • V07.39 Need for other prophylactic chemotherapy

ICD10

  • I38 Endocarditis, valve unspecified

  • I3...

FAQ

  • Q: I forgot to give my child antibiotics prior to the procedure. Should I give him a dose afterward?

  • A: The dosage may be administered up to 2 hours after the procedure.

  • Q: SBE prophylaxis is recomm...

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