BACK TOTOP Browse A-ZSearchBrowse A-ZABCDEFGHIJKLMNOPQRSTUVWXYZ0-9 E-mail FormEmail ResultsName:Email address:Recipients Name:Recipients address:Message: Print-FriendlyBookmarksbookmarks-menuEndocarditis - childrenValve infection - children; Staphylococcus aureus - endocarditis - children; Enterococcus - endocarditis- children; Streptococcus viridians - endocarditis - children; Candida - endocarditis - children; Bacterial endocarditis - children; Infective endocarditis - children; Congenital heart disease - endocarditis - childrenThe inner lining of the heart chambers and heart valves is called the endocardium. Endocarditis occurs when this tissue becomes swollen or inflamed, most often due to infection at the heart valves. Causes Endocarditis occurs when germs enter the bloodstream and then travel to the heart.Bacterial infection is the most common cause Fungal infections are much more rare In some cases, no germs can be found after testing Endocarditis can involve the heart muscle, heart valves, or lining of the heart. Children with endocarditis may have an underlying condition such as:Birth defect of the heart Birth defect of the heartCongenital heart disease (CHD) is a problem with the heart's structure and function that is present at birth.ImageRead Article Now Book Mark Article Damaged or abnormal heart valve New heart valve after surgery The risk is higher in children who have a history of heart surgery, which can leave rough areas in the lining of the heart chambers.This makes it easier for bacteria to stick to the lining.Germs may enter the bloodstream:By way of a central venous access line that is in place Central venous access lineYou have a central line. This is a long tube (catheter) that goes into a vein in your chest, arm, or groin and ends in your heart or in a large vein...Read Article Now Book Mark Article During dental surgery During other surgeries or minor procedures to the airways and lungs, urinary tract, infected skin, or bones and muscles Migration of bacteria from the bowel, mouth, or throat Symptoms Symptoms of endocarditis may develop slowly or suddenly.Fever, chills, and sweating are frequent symptoms. These sometimes can:FeverFever is the temporary increase in the body's temperature in response to a disease or illness. A child has a fever when the temperature is at or abov...ImageRead Article Now Book Mark Article ChillsChills refers to feeling cold after being in a cold environment. The word can also refer to an episode of shivering along with paleness and feeling ...ImageRead Article Now Book Mark Article SweatingSweating is the release of liquid from the body's sweat glands. This liquid contains salt. This process is also called perspiration. Sweating helps...ImageRead Article Now Book Mark Article Be present for days before any other symptoms appear Come and go, or be more noticeable at nighttime Other symptoms may include:Tiredness TirednessFatigue is a feeling of weariness, tiredness, or lack of energy.Read Article Now Book Mark Article Weakness WeaknessWeakness is reduced strength in one or more muscles.Read Article Now Book Mark Article Joint pain Joint painJoint pain can affect one or more joints.ImageRead Article Now Book Mark Article Muscle pain Muscle painMuscle aches and pains are common and can involve more than one muscle. Muscle pain also can involve ligaments, tendons, and fascia. Fascias are th...ImageRead Article Now Book Mark Article Trouble breathing Weight loss Loss of appetiteNeurological problems, such as seizures and disturbed mental statusSeizuresA seizure is the physical changes in behavior that occurs during an episode of specific types of abnormal electrical activity in the brain. The term ...ImageRead Article Now Book Mark Article Signs of endocarditis can also include:Small bleeding areas under the nails (splinter hemorrhages) Splinter hemorrhagesSplinter hemorrhages are small areas of bleeding (hemorrhage) under the fingernails or toenails.Read Article Now Book Mark Article Red, painless skin spots on the palms and soles (Janeway lesions) Red, painful nodes in the pads of the fingers and toes (Osler nodes) Shortness of breath Shortness of breathBreathing difficulty may involve:Difficult breathing Uncomfortable breathingFeeling like you are not getting enough airImageRead Article Now Book Mark Article Swelling of feet, legs, abdomen Exams and Tests Your child's health care provider may perform transthoracic echocardiography (TTE) to check for endocarditis in children age 10 years or younger.Transthoracic echocardiography (TTE)An echocardiogram is a test that uses sound waves to create pictures of the heart. The picture and information it produces is more detailed than a s...ImageRead Article Now Book Mark Article Other tests may include:Blood culture to help identify the bacteria or fungus that is causing the infection Blood cultureA blood culture is a laboratory test to check for bacteria or other germs in a blood sample.ImageRead Article Now Book Mark Article Complete blood count (CBC) Complete blood count (CBC)A complete blood count (CBC) test measures the following:The number of white blood cells (WBC count)The number of red blood cells (RBC count)The numb...ImageRead Article Now Book Mark Article C-reactive protein (CRP) or erythrocyte sedimentation rate (ESR)Erythrocyte sedimentation rate (ESR)ESR stands for erythrocyte sedimentation rate. It is commonly called a "sed rate. "It is a test that indirectly measures the level of certain protei...ImageRead Article Now Book Mark Article Treatment Treatment for endocarditis depends upon the:Cause of the infection Child's age Severity of the symptomsYour child will need to be in the hospital to receive antibiotics through a vein (IV). Blood cultures and tests will help the provider choose the best antibiotic.Your child will need long-term antibiotic therapy.Your child will need this therapy for 4 to 8 weeks to fully kill all the bacteria from the heart chambers and valves. Antibiotic treatments started in the hospital will need to be continued at home once your child is stable.Surgery to replace an infected heart valve may be needed when:Antibiotics don't work to treat the infection The infection is breaking off in little pieces, resulting in strokes The child develops heart failure as a result of damaged heart valves The heart valve is badly damaged Outlook (Prognosis) Getting treatment for endocarditis right away improves the chances of clearing the infection and preventing complications. Possible Complications The possible complications of endocarditis in children are:Damage to the heart and heart valves Abscess in the heart muscle Infective clot in the coronary arteries Stroke, caused by small clots or pieces of the infection breaking off and traveling to the brain StrokeA stroke occurs when blood flow to a part of the brain stops. A stroke is sometimes called a "brain attack. " If blood flow is cut off for longer th...ImageRead Article Now Book Mark Article Spread of the infection to other parts of the body, such as the lungs When to Contact a Medical Professional Call your child's provider if you notice the following symptoms during or after treatment:Blood in urine Chest pain Chest painChest pain is discomfort or pain that you feel anywhere along the front of your body between your neck and upper abdomen.ImageRead Article Now Book Mark Article Fatigue Fever Numbness NumbnessNumbness and tingling are abnormal sensations that can occur anywhere in your body, but they are often felt in your fingers, hands, feet, arms, or le...ImageRead Article Now Book Mark Article Weakness Weight loss without a change in dietWeight lossUnexplained weight loss is a decrease in body weight, when you did not try to lose the weight on your own. Many people gain and lose weight. Uninten...Read Article Now Book Mark Article Prevention The American Heart Association recommends preventive antibiotics for children at risk for endocarditis, such as those with:Certain corrected or uncorrected birth defects of the heart Heart transplant and valve problems Man-made (prosthetic) heart valves A past history of endocarditisThese children should receive antibiotics when they have:Dental procedures that are likely to cause bleeding Procedures involving the breathing tract, the urinary tract, or the digestive tract Procedures on skin infections and soft tissue infectionsOpen ReferencesReferencesBaltimore RS, Gewitz M, Baddour LM, et al; American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee of the Council on Cardiovascular Disease in the Young and the Council on Cardiovascular and Stroke Nursing. Infective endocarditis in childhood: 2015 update: a scientific statement from the American Heart Association. Circulation. 2015;132(15):1487-1515. PMID: 26373317 www.ncbi.nlm.nih.gov/pubmed/26373317.Kaplan SL, Vallejo JG. Infective endocarditis. In: Cherry JD, Harrison GJ, Kaplan SL, Steinbach WJ, Hotez PJ, eds. Feigin and Cherry's Textbook of Pediatric Infectious Diseases. 8th ed. Philadelphia, PA: Elsevier; 2019:chap 26. Marcdante KJ, Kliegman RM, Schuh AM. Infective endocarditis. In: Marcdante KJ, Kliegman RM, Schuch AM, eds. Nelson Essentials of Pediatrics. 9th ed. Philadelphia, PA: Elsevier; 2023:chap 111.Mick NW. Pediatric fever. In: Walls RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 161.AllVideoImagesTogHeart valves - superior view - illustration There are four valves located in the heart. Each valve either consists of two or three folds of thin tissue. When closed, the valve prevents blood from flowing backwards to its previous location. When open the valve allows blood to flow freely. Valve problems can occur because of congenital abnormalities, infection, or other causes.Heart valves - superior viewillustrationCulture-negative endocarditis - illustration Endocarditis is an infection and inflammation of the valves in the heart. When the infection cannot be cultured and linked to any causative organism from the bloodstream, it is referred to as culture-negative endocarditis.Culture-negative endocarditisillustrationInfective endocarditis - illustration Infectious endocarditis involves the heart valves and is most commonly found in people who have underlying heart disease. Sources of the infection may be transient bacteremia, which is common during dental, upper respiratory, urologic, and lower gastrointestinal diagnostic and surgical procedures. The infection can cause growths on the heart valves, the lining of the heart, or the lining of the blood vessels. These growths may be dislodged and send clots to the brain, lungs, kidneys, or spleen.Infective endocarditisillustrationHeart valves - superior view - illustration There are four valves located in the heart. Each valve either consists of two or three folds of thin tissue. When closed, the valve prevents blood from flowing backwards to its previous location. When open the valve allows blood to flow freely. Valve problems can occur because of congenital abnormalities, infection, or other causes.Heart valves - superior viewillustrationCulture-negative endocarditis - illustration Endocarditis is an infection and inflammation of the valves in the heart. When the infection cannot be cultured and linked to any causative organism from the bloodstream, it is referred to as culture-negative endocarditis.Culture-negative endocarditisillustrationInfective endocarditis - illustration Infectious endocarditis involves the heart valves and is most commonly found in people who have underlying heart disease. Sources of the infection may be transient bacteremia, which is common during dental, upper respiratory, urologic, and lower gastrointestinal diagnostic and surgical procedures. The infection can cause growths on the heart valves, the lining of the heart, or the lining of the blood vessels. These growths may be dislodged and send clots to the brain, lungs, kidneys, or spleen.Infective endocarditisillustrationRelated Information Review Date: 5/8/2022 Reviewed By: Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. No warranty of any kind, either expressed or implied, is made as to the accuracy, reliability, timeliness, or correctness of any translations made by a third-party service of the information provided herein into any other language. © 1997- A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited. © 1997- All rights reserved. A.D.A.M. content is best viewed in IE9 or above, Firefox and Google Chrome browser.Content is best viewed in IE9 or above, Firefox and Google Chrome browser.
Endocarditis - childrenValve infection - children; Staphylococcus aureus - endocarditis - children; Enterococcus - endocarditis- children; Streptococcus viridians - endocarditis - children; Candida - endocarditis - children; Bacterial endocarditis - children; Infective endocarditis - children; Congenital heart disease - endocarditis - childrenThe inner lining of the heart chambers and heart valves is called the endocardium. Endocarditis occurs when this tissue becomes swollen or inflamed, most often due to infection at the heart valves. Causes Endocarditis occurs when germs enter the bloodstream and then travel to the heart.Bacterial infection is the most common cause Fungal infections are much more rare In some cases, no germs can be found after testing Endocarditis can involve the heart muscle, heart valves, or lining of the heart. Children with endocarditis may have an underlying condition such as:Birth defect of the heart Birth defect of the heartCongenital heart disease (CHD) is a problem with the heart's structure and function that is present at birth.ImageRead Article Now Book Mark Article Damaged or abnormal heart valve New heart valve after surgery The risk is higher in children who have a history of heart surgery, which can leave rough areas in the lining of the heart chambers.This makes it easier for bacteria to stick to the lining.Germs may enter the bloodstream:By way of a central venous access line that is in place Central venous access lineYou have a central line. This is a long tube (catheter) that goes into a vein in your chest, arm, or groin and ends in your heart or in a large vein...Read Article Now Book Mark Article During dental surgery During other surgeries or minor procedures to the airways and lungs, urinary tract, infected skin, or bones and muscles Migration of bacteria from the bowel, mouth, or throat Symptoms Symptoms of endocarditis may develop slowly or suddenly.Fever, chills, and sweating are frequent symptoms. These sometimes can:FeverFever is the temporary increase in the body's temperature in response to a disease or illness. A child has a fever when the temperature is at or abov...ImageRead Article Now Book Mark Article ChillsChills refers to feeling cold after being in a cold environment. The word can also refer to an episode of shivering along with paleness and feeling ...ImageRead Article Now Book Mark Article SweatingSweating is the release of liquid from the body's sweat glands. This liquid contains salt. This process is also called perspiration. Sweating helps...ImageRead Article Now Book Mark Article Be present for days before any other symptoms appear Come and go, or be more noticeable at nighttime Other symptoms may include:Tiredness TirednessFatigue is a feeling of weariness, tiredness, or lack of energy.Read Article Now Book Mark Article Weakness WeaknessWeakness is reduced strength in one or more muscles.Read Article Now Book Mark Article Joint pain Joint painJoint pain can affect one or more joints.ImageRead Article Now Book Mark Article Muscle pain Muscle painMuscle aches and pains are common and can involve more than one muscle. Muscle pain also can involve ligaments, tendons, and fascia. Fascias are th...ImageRead Article Now Book Mark Article Trouble breathing Weight loss Loss of appetiteNeurological problems, such as seizures and disturbed mental statusSeizuresA seizure is the physical changes in behavior that occurs during an episode of specific types of abnormal electrical activity in the brain. The term ...ImageRead Article Now Book Mark Article Signs of endocarditis can also include:Small bleeding areas under the nails (splinter hemorrhages) Splinter hemorrhagesSplinter hemorrhages are small areas of bleeding (hemorrhage) under the fingernails or toenails.Read Article Now Book Mark Article Red, painless skin spots on the palms and soles (Janeway lesions) Red, painful nodes in the pads of the fingers and toes (Osler nodes) Shortness of breath Shortness of breathBreathing difficulty may involve:Difficult breathing Uncomfortable breathingFeeling like you are not getting enough airImageRead Article Now Book Mark Article Swelling of feet, legs, abdomen Exams and Tests Your child's health care provider may perform transthoracic echocardiography (TTE) to check for endocarditis in children age 10 years or younger.Transthoracic echocardiography (TTE)An echocardiogram is a test that uses sound waves to create pictures of the heart. The picture and information it produces is more detailed than a s...ImageRead Article Now Book Mark Article Other tests may include:Blood culture to help identify the bacteria or fungus that is causing the infection Blood cultureA blood culture is a laboratory test to check for bacteria or other germs in a blood sample.ImageRead Article Now Book Mark Article Complete blood count (CBC) Complete blood count (CBC)A complete blood count (CBC) test measures the following:The number of white blood cells (WBC count)The number of red blood cells (RBC count)The numb...ImageRead Article Now Book Mark Article C-reactive protein (CRP) or erythrocyte sedimentation rate (ESR)Erythrocyte sedimentation rate (ESR)ESR stands for erythrocyte sedimentation rate. It is commonly called a "sed rate. "It is a test that indirectly measures the level of certain protei...ImageRead Article Now Book Mark Article Treatment Treatment for endocarditis depends upon the:Cause of the infection Child's age Severity of the symptomsYour child will need to be in the hospital to receive antibiotics through a vein (IV). Blood cultures and tests will help the provider choose the best antibiotic.Your child will need long-term antibiotic therapy.Your child will need this therapy for 4 to 8 weeks to fully kill all the bacteria from the heart chambers and valves. Antibiotic treatments started in the hospital will need to be continued at home once your child is stable.Surgery to replace an infected heart valve may be needed when:Antibiotics don't work to treat the infection The infection is breaking off in little pieces, resulting in strokes The child develops heart failure as a result of damaged heart valves The heart valve is badly damaged Outlook (Prognosis) Getting treatment for endocarditis right away improves the chances of clearing the infection and preventing complications. Possible Complications The possible complications of endocarditis in children are:Damage to the heart and heart valves Abscess in the heart muscle Infective clot in the coronary arteries Stroke, caused by small clots or pieces of the infection breaking off and traveling to the brain StrokeA stroke occurs when blood flow to a part of the brain stops. A stroke is sometimes called a "brain attack. " If blood flow is cut off for longer th...ImageRead Article Now Book Mark Article Spread of the infection to other parts of the body, such as the lungs When to Contact a Medical Professional Call your child's provider if you notice the following symptoms during or after treatment:Blood in urine Chest pain Chest painChest pain is discomfort or pain that you feel anywhere along the front of your body between your neck and upper abdomen.ImageRead Article Now Book Mark Article Fatigue Fever Numbness NumbnessNumbness and tingling are abnormal sensations that can occur anywhere in your body, but they are often felt in your fingers, hands, feet, arms, or le...ImageRead Article Now Book Mark Article Weakness Weight loss without a change in dietWeight lossUnexplained weight loss is a decrease in body weight, when you did not try to lose the weight on your own. Many people gain and lose weight. Uninten...Read Article Now Book Mark Article Prevention The American Heart Association recommends preventive antibiotics for children at risk for endocarditis, such as those with:Certain corrected or uncorrected birth defects of the heart Heart transplant and valve problems Man-made (prosthetic) heart valves A past history of endocarditisThese children should receive antibiotics when they have:Dental procedures that are likely to cause bleeding Procedures involving the breathing tract, the urinary tract, or the digestive tract Procedures on skin infections and soft tissue infectionsOpen ReferencesReferencesBaltimore RS, Gewitz M, Baddour LM, et al; American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee of the Council on Cardiovascular Disease in the Young and the Council on Cardiovascular and Stroke Nursing. Infective endocarditis in childhood: 2015 update: a scientific statement from the American Heart Association. Circulation. 2015;132(15):1487-1515. PMID: 26373317 www.ncbi.nlm.nih.gov/pubmed/26373317.Kaplan SL, Vallejo JG. Infective endocarditis. In: Cherry JD, Harrison GJ, Kaplan SL, Steinbach WJ, Hotez PJ, eds. Feigin and Cherry's Textbook of Pediatric Infectious Diseases. 8th ed. Philadelphia, PA: Elsevier; 2019:chap 26. Marcdante KJ, Kliegman RM, Schuh AM. Infective endocarditis. In: Marcdante KJ, Kliegman RM, Schuch AM, eds. Nelson Essentials of Pediatrics. 9th ed. Philadelphia, PA: Elsevier; 2023:chap 111.Mick NW. Pediatric fever. In: Walls RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 161.