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ENDOCARDITIS (Bacterial Endocarditis; Infective Endocarditis)

ENDOCARDITIS (Bacterial Endocarditis; Infective Endocarditis)

DESCRIPTION

Endocarditis is a severe and sometimes life-threatening non-contagious infection of the valves or lining of the heart. The heart muscle, heart valves, and endocardium (lining of the heart chambers and valves) are involved.
Appropriate health care includes:
  • Physician's monitoring of general condition and medications.
  • Hospitalization until the acute illness subsides.
  • Self-care after the acute illness.

    SIGNS & SYMPTOMS
    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 child's feet, legs, and abdomen.
  • Rapid or irregular heartbeat.

    CAUSES

    RISK FACTORS
    ). Bacteria or fungi further damage the heart valves, muscles, and linings.

    RISK FACTORS
    Risk of heart-valve damage increases with:

  • Rheumatic fever.
  • Congenital heart disease. Risk of endocarditis following heart-valve damage increases with:
  • Pregnancy.
  • Injections of contaminated materials into the child's bloodstream, such as with self-administered intravenous drugs.
  • Use of immunosuppressive drugs.
  • Artificial heart valves.
  • Excess alcohol consumption.

    PREVENTING COMPLICATIONS OR RECURRENCE

    Instructions for a child who 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, childbirth, and surgery of the urinary or gastrointestinal tract.
  • Consult your doctor before becoming pregnant.
  • Don't use mind-altering drugs.
  • Don't drink more than 1 or 2--if any--alcoholic drinks a day.

    BASIC INFORMATION

    MEDICAL TESTS

    Your own observation of symptoms; medical history and physical exam by a doctor; laboratory blood counts and blood cultures; EKG (See Glossary); X-rays of the child's heart and lungs, including echocardiogram (See Glossary).

    POSSIBLE COMPLICATIONS

  • Blood clots that may travel to the brain, kidneys, or abdominal organs, causing infections, abscesses, or stroke.
  • Heart-rhythm disturbances (atrial fibrillation is most common).

    PROBABLE OUTCOME
    Usually curable with early diagnosis and treatment. If treatment is delayed, your child's heart function may deteriorate, resulting in congestive heart failure and death.

    TREATMENT

    HOME CARE

  • If your child has damaged valves, tell your doctor and dentist before treatment.
  • After having endocarditis, your child should stay under a doctor's care to prevent a relapse.

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

    ACTIVITY

  • Your child should rest in bed until fully recovered. While in bed, flexing the legs often helps prevent clots from forming in deep veins.
  • Your child can resume normal activities when strength allows.

    DIET & FLUIDS
    No special diet, unless your child has an underlying heart disorder. In that case, the child should follow a low-salt diet (See Appendix 29).

    OK TO GO TO SCHOOL?

    When signs of infection have decreased, appetite returns, and alertness, strength, and feeling of well-being will allow.

    CALL YOUR DOCTOR IF

  • Your child has symptoms of endocarditis.
  • The following occurs during or after treatment: weight gain without diet changes; blood in the child's urine; chest pain; sudden weakness or numbness in the muscles of the child's face, trunk, or limbs. ‡
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