Related Experiment Video
Updated: May 13, 2026
08:38
A Neonatal Heterotopic Rat Heart Transplantation Model for the Study of Endothelial-to-Mesenchymal Transition
Published on: July 21, 2023
Infective endocarditis in previously healthy children with structurally normal hearts
Daphna Marom1, Shai Ashkenazi, Zmira Samra
1Department of Pediatrics A, Schneider Children's Medical Center, Petach Tikva, Israel. dmarom@clalit.org.il
Pediatric Cardiology
|March 14, 2013
Summary
Infective endocarditis (IE) in children with structurally normal hearts presents acutely with high complication rates. Prompt diagnosis and pediatrician awareness are crucial for this distinct pediatric IE subgroup.
Area of Science:
- Pediatric Cardiology
- Infectious Diseases
- Critical Care Medicine
Background:
- Infective endocarditis (IE) typically affects individuals with structural heart disease or invasive devices.
- Limited data exists on IE in pediatric patients with structurally normal hearts and no predisposing factors.
- Understanding this subgroup is vital for accurate diagnosis and management.
Purpose of the Study:
- To characterize infective endocarditis (IE) in pediatric patients (<18 years) with structurally normal hearts and no predisposing factors.
- To compare IE characteristics between children with and without predisposing factors.
Main Methods:
- Retrospective review of 51 IE events in 50 pediatric patients treated at a single medical center.
- Patients categorized into groups with and without predisposing factors (structural heart disease, catheters, invasive procedures).
- Duke criteria used for IE classification; data analyzed for clinical presentation, causative organisms, complications, and outcomes.
Main Results:
- Nine percent (18%) of pediatric IE cases occurred in children without predisposing factors; these were community-acquired with acute onset, fever, new murmur, and left-sided infection.
- Children without predisposing factors experienced a 100% complication rate (heart failure, embolic phenomena) and required emergency cardiac surgery (7/9).
- IE in children with predisposing factors (82%) was more frequently healthcare-associated, right-sided, and had lower rates of echocardiographic findings, complications, and surgery.
Conclusions:
- Pediatric infective endocarditis (IE) presents differently in children with and without predisposing factors.
- IE in children with structurally normal hearts is characterized by acute onset and severe complications, necessitating high clinical suspicion.
- Enhanced awareness and prompt diagnosis by pediatricians are critical for managing this distinct IE population.
Related Concept Videos
01:25Endocarditis I: Introduction
Introduction:Endocarditis is the infection of the endocardium, the inner lining of the heart and its valves. When the heart muscle is involved, the condition is termed myocarditis, while an infection of the outer lining is called pericarditis. Infective endocarditis (IE) primarily affects the endocardium, where pathogens adhere to the valves or lining, forming vegetation that can lead to severe complications. Infective endocarditis occurs when microorganisms, usually bacteria from other body...
01:25Endocarditis II: Clinical Features of Infective Endocarditis
Endocarditis can present various clinical features depending on the causative organism and the patient's underlying health conditions. Initially, the clinical features of infective endocarditis develop gradually, presenting with nonspecific symptoms that can be easily mistaken for other illnesses.General SymptomsEarly symptoms of infective endocarditis are fever, chills, weakness, malaise, fatigue, and weight loss. These symptoms reflect the systemic nature of the infection and the body's...
01:29Endocarditis IV: Nursing Management
Infective endocarditis (IE) is a chronic infection of the heart's endocardium, primarily affecting the heart valves. A detailed nursing assessment for a patient with IE involves collecting subjective and objective data to ensure an accurate diagnosis and timely intervention.Subjective DataThe nurse gathers information about the patient's symptoms and complaints during the subjective assessment. Patients with infective endocarditis often report non-specific symptoms that can mimic other...
01:23Rheumatic Heart Disease I: Introduction
Rheumatic heart disease or RHD is a chronic condition that results from rheumatic fever, causing permanent damage to the heart valves.Etiology and Risk FactorsIt primarily arises from rheumatic fever, an inflammatory disease that can develop after untreated or inadequately treated group A streptococcal (GAS) pharyngitis. Streptococcus spreads through direct contact with oral or respiratory secretions. While the bacteria are the causative agents, factors like malnutrition, overcrowding, poor...
01:18Endocarditis III: Medical Management
Infective endocarditis management involves a multifaceted approach encompassing infection prevention, lifestyle modifications, pharmacological therapy, and surgical management.Infection Prevention:Hand Hygiene: Thorough handwashing is crucial to prevent the spread of infection. Hand hygiene should be performed regularly, especially before and after using the restroom.Oral Hygiene: Good oral hygiene is essential. It includes brushing teeth immediately after waking up and before bed, flossing...
01:21Myocarditis I: Introduction
Myocarditis is inflammation of the myocardium, which is the muscular layer of the heart.EtiologyMyocarditis has a diverse etiology, including a wide range of infectious and non-infectious causes:Infectious CausesViral: Common viruses include Coxsackie A and B, adenovirus, parvovirus B19, enteroviruses, and influenza A.Bacterial: Examples include infections caused by Streptococcus, Staphylococcus, and Mycoplasma species.Rickettsial: Infections like Rocky Mountain spotted fever can result in...