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.

PubMed

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.

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