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ENDOCARDITIS-BACTERIAL

Definition:

A non-contagious infection of the valves or lining of the heart, commonly involving heart muscle, heart valves and endocardium (inner lining of the heart chambers and valves).

Sex or Age most Affected

Equally affects both sexes and all ages.

Signs & Symptons

Early symptoms:

  • Fatigue and weakness.
  • Intermittent fever, chills and excessive sweating, especially at night.
  • Weight loss.
  • Vague aches and pains.
  • Heart murmur.

Late Symptoms

  • Severe chills and high fever.
  • Shortness of breath on exertion.
  • Swelling of the feet, legs and abdomen.
  • Rapid or irregular heartbeat.

Causes

Bacteria or fungi that enter the blood and infect the valves and heart lining of children with damaged hearts (see risks below), thus causing further damage to the heart valves, muscles and linings.

Risk Increases With

Risk of heart-valve damage increases with:

  • Rheumatic fever.
  • Congenital heart disease.

Risk of endocarditis following heart-valve damage increases with:

  • Pregnancy.
  • Excess alcohol consumption.
  • Use of immunosuppressive drugs.
  • Artificial heart valves.

Prevention

If your child has heart-valve damage or a heart murmur:

Request antibiotics prior to medical procedures that may introduce bacteria into the blood. These include dental work and surgery of the urinary or gastrointestinal tract.

Diagnostic Measures

  • Medical history and physical exam by a doctor.
  • Observation of symptoms.
  • Laboratory blood counts and blood cultures.
  • ECG.
  • X-rays of the heart and lungs, including 2-D Echocardiogram.

Possible Complications

� Blood clots that may travel to the brain, kidneys or abdominal organs, causing infections, abscesses or stroke.

� Disturbances of the Heart-rhythm (atrial fibrillation is most common).

Probable Outcomes

Usually curable with early diagnosis and treatment, but recovery may take weeks. If treatment is delayed, heart function deteriorates, resulting in congestive heart failure and death.

TREATMENT

General Measures

� If your child has damaged heart valves, tell his doctor and dentist.

� After an episode of endocarditis, stay under a doctor’s care to prevent a relapse.

 

Medication

Your doctor may prescribe antibiotics for many weeks to fight infection. Antibiotic treatment is often intravenous.

Activity

Rest in bed until full recovery. While in bed, legs to be flexed, often, to prevent clots forming in deep veins.

Diet

No special diet, unless there is an underlying heart disorder. In that case, follow a low-salt diet.

Contact your Doctor

Any symptoms of endocarditis.

The following occurs during or after treatment:

  • Weight gain without diet changes.
  • Blood in the urine.
  • Chest pain.
  • Sudden weakness or numbness in muscles of the face, trunk or limbs.