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Infective endocarditis in children: an update
1aDepartment of Microbiology, Virology, Infection Prevention and Control bCardiothoracic Unit, Great Ormond Street Hospital, NHS Foundation Trust, London, UK.
Current Opinion in Infectious Diseases
|March 21, 2017
Summary
Pediatric infective endocarditis management is evolving with new guidelines and diagnostic tools. Device-related infections, particularly after valve implantation, are a growing concern, while prophylaxis impacts remain uncertain.
Area of Science:
- Pediatric Cardiology
- Infectious Diseases
- Cardiovascular Surgery
Background:
- Infective endocarditis (IE) in children presents ongoing clinical challenges.
- Management strategies are influenced by updated guidelines and evolving risk factors.
Purpose of the Study:
- To review the impact of the 2015 American Heart Association and European Society of Cardiology guidelines on pediatric IE management.
- To assess the significance of new predisposing factors, diagnostic and treatment options, and prophylaxis recommendations.
Main Methods:
- Review of updated guidelines and recent literature on pediatric infective endocarditis.
- Analysis of diagnostic criteria including new imaging modalities (CT, PET-CT).
- Evaluation of treatment strategies, including early surgical intervention and device-related IE.
Main Results:
- The 2015 guidelines introduced the endocarditis team and incorporated advanced imaging (CT, PET-CT).
- The impact of revised prophylaxis recommendations (since 2007-2008) on IE incidence is uncertain, with conflicting study results.
- Device-related IE, especially following percutaneous pulmonary valve implantation, is increasing, presenting unique challenges.
Conclusions:
- The effect of altered IE prophylaxis on pediatric patients remains unclear.
- Device-related IE, particularly on transcatheter pulmonary valves, is a significant and growing concern.
- Novel imaging, diagnostics, and timely surgical intervention are crucial for managing pediatric IE.
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