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Infective Endocarditis in Children as an Increasing Clinical Problem-A Case Series
Urszula Abramczyk1, Paweł Cześniewicz1, Jacek Kusa2
1Department of Pediatric Cardiology, Regional Specialist Hospital, Research and Development Center, 51-124 Wroclaw, Poland.
Insights
Infective endocarditis (IE) is a growing concern in younger populations, particularly children with congenital heart disease (CHD). This study highlights the increasing complexity of IE cases and the urgent need for pediatric-specific management guidelines.
Area of Science:
- Cardiology
- Pediatric Medicine
- Infectious Diseases
Background:
- Infective endocarditis (IE) is a serious condition affecting a growing number of younger individuals, including children with congenital heart disease (CHD) and young adults post-cardiac surgery.
- The European Society of Cardiology (ESC) released new endocarditis management guidelines in September 2023, but these do not specifically address pediatric populations.
- There is a critical need to raise awareness regarding the rising incidence and complexity of IE in pediatric patients.
Observation:
- This study reviewed eight pediatric IE cases treated in 2023, focusing on four particularly complex cases.
- All described patients had congenital heart disease (CHD) and presented with diverse clinical manifestations of IE.
- The diagnostic process required a comprehensive approach utilizing all available methods.
Findings:
- Pediatric IE cases are increasing and present with complex clinical courses.
- All patients required specialized treatment and subsequent cardiac surgery.
- The diverse presentation of IE in pediatric patients necessitates a tailored diagnostic strategy.
Implications:
- Physicians face significant challenges in managing IE, especially in pediatric patients with CHD and a history of multiple cardiac surgeries.
- The lack of specific pediatric endocarditis guidelines requires adaptation of adult protocols and reliance on case studies.
- Further research and development of pediatric-specific IE management guidelines are crucial.
Abstract:
In September 2023, the European Society of Cardiology (ESC) published new guidelines for the management of endocarditis. Infective endocarditis (IE) remains a significant life-threatening disease, concerning an increasingly younger age group, especially children with congenital heart disease (CHD) and young adults after multiple cardiac surgeries. This study's aim was to alert the medical community to the problem of increasing IE case numbers and IE course complexity. Of the eight patients who suffered from IE treated in 2023 in our department, we describe the four whose course was the most extraordinary. Afterward, we compared the number of IE patients treated over the years in our department. All cases described children with congenital heart disease suffering from IE. The IE clinical presentation in all patients was extremely diverse, necessitating the utilization of all available diagnostic methods. Each child underwent specialized treatment and subsequently qualified for cardiac surgery. While the etiology and treatment of IE are well established, it remains a formidable challenge for physicians. Pediatric patients who have undergone multiple cardiac surgeries constitute a steadily expanding group and are especially susceptible to IE throughout their lives. Currently, no recommendations exist for the management of endocarditis in pediatric patients. This gap compels pediatricians to adapt existing guidelines designed for adult patients and to rely on scientific reports, such as case studies.
Related Concept Videos
Endocarditis I: Introduction
Endocarditis II: Clinical Features of Infective Endocarditis
Endocarditis III: Medical Management
Endocarditis IV: Nursing Management
Myocarditis II: Clinical Features and Diagnostic Tests
Myocarditis III: Medical Management

