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Published on: February 9, 2011

Infective endocarditis: experience of a paediatric emergency department

Stuart Lewena1

  • 1Princess Margaret Hospital for Children, Perth, Western Australia, Australia. stuart.lewena@rch.org.au

Journal of Paediatrics and Child Health
|June 15, 2005
PubMed

Insights

Pediatric infective endocarditis is a rare, challenging diagnosis. Most children present to the emergency department with non-specific symptoms, often after receiving antibiotics for other conditions.

Area of Science:

  • Pediatric Cardiology
  • Infectious Diseases
  • Emergency Medicine

Background:

  • Infective endocarditis (IE) is a rare but serious infection affecting heart valves.
  • Early diagnosis and treatment are crucial for improving outcomes in pediatric IE.
  • Diagnostic challenges exist, particularly in non-specific presentations.

Purpose of the Study:

  • To describe the clinical features of pediatric infective endocarditis at presentation.
  • To evaluate the role of the emergency department in diagnosing and managing pediatric IE.
  • To review the course and outcomes of pediatric IE.

Main Methods:

  • Retrospective audit of pediatric IE cases over 16 years at a tertiary children's hospital.
  • Analysis of presentation, prior medical care, causative organisms, and outcomes.
  • Comparison of outcomes based on cardiac anatomy and causative organism.

Main Results:

  • 78% of 23 identified pediatric IE cases presented to the emergency department, with shortest treatment delay.
  • Staphylococcus aureus was the most common pathogen (43%), especially in those without cardiac anomalies.
  • Significant morbidity occurred, particularly with S. aureus; overall mortality was 9%.

Conclusions:

  • Pediatric infective endocarditis presents diagnostic challenges, often with non-specific symptoms in the emergency department.
  • Early recognition and management, supported by pediatric emergency expertise, are vital.
  • Morbidity is significant, with S. aureus posing a particular risk.
Abstract

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