ETIOLOGY

Common cause:-
 Viridans group streptococci
 Staphylococcus aureus
Uncommon cause:-
 Streptococcus pneumoniae
 Hemophilius influenza
 Chlamydia
 Q fever
 Hacek group ( hemophilius, actinobaccillus, cardio
bacterium, eikenella & kingella)
 Other causes:-
 Dental procedures
 Adenoidectomy
 Medical procedures
 Surgery of the respiratory system , GI system &
urinary tract.

RISK FACTORS:-
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
CLINICAL MANIFESTATIONS:-
SYMPTOMS-
 Prolonged fever
 Chills
 Night sweat
 Weight loss
 Chest and abdominal pain
 Arthralgia,myalgia
 Dyspnea
 Malaise
 CVS- stroke, seizures, headache
SIGNS:-
 Osler's sign- painful red fingers/toes
 Janeway lesions- painless lesion on palms/soles
 Splinter hemorrhage- a tiny blood spots underneath of
faingernails/ toenails.
 Roth spot- white centered retinal hemorrhage
 DIAGNOSTIC EVALUATION:-

The healthcare provider will ask about the child’s

symptoms and health history. He or she will give child's
physical exam and listen to the child's heart. Other tests
may include:
 Echocardiogram (echo). This test looks at the
structure of the child's heart and how well it is working. It
uses sound waves to make a moving picture of the heart
and heart valves. The healthcare provider may be able to
show a heart valve infection.
 Complete blood count (CBC). This test looks at all
types of cells in the child's blood. These are red cells,
white cells, and platelets.
 Blood culture. This test looks for infection in the
child's blood.
 DUKE CRITERIA.
 MANAGEMENT:-

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 the child.
Treatment includes:
 Antibiotics. Antibiotics are usually given through the
vein (IV) for several weeks. The 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.

child will need ongoing care, including:

 Repeat echocardiograms and blood tests after the
infection
 Regular health checkups
 Regular dental checkups
 Good daily oral hygiene (brushing and flossing)

PREVENTION:-
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.