Bacterial Endocarditis in Children
What is bacterial endocarditis in children?
Bacterial endocarditis is an infection of the lining of the heart (endocardium), and the heart valves. It doesn't occur very often, but when it does, it can cause serious heart damage.
Bacterial endocarditis occurs when bacteria in the blood enter the heart and cause infection.
What causes bacterial endocarditis in a child?
Bacteria can enter the body in many ways. Having heart problems, especially with the valves, raises the chance that bacteria will affect the heart. Some of the most common ways bacteria get into the blood include:
Dental work, such as professional teeth cleaning
Surgery to remove the tonsils or adenoids
Medical procedures, such as an exam of the airways with a bronchoscope
Surgery, such as some respiratory, gastrointestinal, or urinary tract surgeries
Which children are at risk for bacterial endocarditis?
Your child is at higher risk for bacterial endocarditis if he or she has:
Artificial (prosthetic) heart valves
Had endocarditis in the past
Congenital heart disease
Had a heart transplant, but the heart valves aren't working correctly
Indwelling central venous catheter
Rheumatic heart disease
A weak immune system
Talk with your child's healthcare provider about your child's risk factors.
What are the symptoms of bacterial endocarditis in a child?
Symptoms can occur a bit differently in each child. They can include:
Flu-like symptoms, such as fever, chills, tiredness, aching muscles and joints, night sweats, and headaches
Shortness of breath
Skin changes such as:
Bumps under the skin on the fingers and toes
Spots on the palms of the hands and soles of the feet
Small broken blood vessels with tiny spots under the nails, on the whites of the eyes, in the mouth, or on the chest
Nausea and vomiting, decreased appetite, weight loss
Discomfort in the belly
Blood in the urine
Swelling of the feet, legs, or abdomen
How is bacterial endocarditis diagnosed in a child?
The healthcare provider will ask about your child’s symptoms and health history. He or she will give your child a physical exam and listen to your child's heart. Other tests may include:
Echocardiogram (echo). This test looks at the structure of your child's heart and how well it is working. It uses sound waves to make a moving picture of the heart and heart valves. Your healthcare provider may be able to show a heart valve infection.
Complete blood count (CBC). This test looks at all types of cells in your child's blood. These are red cells, white cells, and platelets.
Blood culture. This test looks for infection in your child's blood.
How is bacterial endocarditis treated in a child?
Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is.
A child heart specialist (pediatric cardiologist) and an infectious disease specialist will take care of your child. Treatment includes:
Antibiotics. Antibiotics are usually given through the vein (IV) for several weeks. Your child will likely be in the hospital to get the medicine. Sometimes these antibiotics can be given at home with the help of a home health team.
Surgery. Some children need valve replacement surgery if there is severe heart valve damage or if the infection can't be cleared due to an abscess.
What are possible complications of bacterial endocarditis in a child?
Complications of bacterial endocarditis include:
Blood clots or clumps of bacteria that travel to other parts of the body (emboli). This might be to the arteries in the heart, brain, spleen, bowel, arms, or legs.
Infection in other parts of the heart
Weakened blood vessel (aneurysm), such as in the brain
What can I do to prevent bacterial endocarditis in my child?
Bacterial endocarditis can't be entirely prevented. But some things can help. They include:
Have your child take very good care of his or her teeth and gums
Take your child to the dentist for regular cleaning and checkups
Practice good hygiene
Have your child take the full prescription of antibiotics when these are used to treat infections such as strep throat
Some children with heart problems need to take antibiotics before some dental and medical procedures. Talk with your child's healthcare provider to find if your child needs antibiotics.
How is bacterial endocarditis managed in a child?
Your child will need ongoing care, including:
When should I call my child's healthcare provider?
Call your child's healthcare provider right away if your child has:
Key points about bacterial endocarditis in children
Bacterial endocarditis is an infection of the lining of the heart, including the valves.
A child with heart problems is at higher risk of getting bacterial endocarditis.
Symptoms are similar to the flu. Other symptoms include a cough, skin changes, and swelling in the arms, legs, or abdomen.
Bacterial endocarditis is treated with antibiotics.
If significant heart valve damage occurs, heart valve replacement surgery may be needed.
Good dental care and body hygiene is an important part of preventing bacterial endocarditis.
Tips to help you get the most from a visit to your healthcare provider:
Know the reason for your visit and what you want to happen.
Before your visit, write down questions you want answered.
Bring someone with you to help you ask questions and remember what your provider tells you.
At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
Ask if your condition can be treated in other ways.
Know why a test or procedure is recommended and what the results could mean.
Know what to expect if you do not take the medicine or have the test or procedure.
If you have a follow-up appointment, write down the date, time, and purpose for that visit.
Know how you can contact your provider if you have questions.