TY - CHAP M1 - Book, Section TI - Chapter 490. Infective Endocarditis A1 - Newburger, Jane W. A2 - Rudolph, Colin D. A2 - Rudolph, Abraham M. A2 - Lister, George E. A2 - First, Lewis R. A2 - Gershon, Anne A. PY - 2011 T2 - Rudolph's Pediatrics, 22e AB - Infective endocarditis (IE) is defined as an infection of the endocardium, generally involving cardiac valves and their valvular apparatus such as the chordae tendinae, interventricular septum, mural endocardium, or intracardiac devices. IE may occur in children with or without antecedent underlying cardiac disease. The diagnosis of IE rests on a constellation of clinical features and laboratory investigations, including blood cultures and echocardiography.1 Most often, IE presents with fever, positive blood cultures, a new murmur, or vegetations by echocardiography. Vascular findings and immunologic phenomena are common. The presenting symptoms, rate of progression, morbidity, and mortality of infective endocarditis depend, in part, upon the underlying heart disease, the etiologic organism, and host factors. Whereas most infective endocarditis is accompanied by positive blood cultures, 5% to 7% are culture negative, sometimes due to administration of antibiotics before blood cultures were obtained.1 Compared to adults, children have a lower incidence and fatality rate of IE.2,3 The most common causes of bacterial endocarditis in children are viridans group streptococci and Staphylococcus aureus; other principal pathogenic agents include coagulase-negative staphylococci, Streptococcus pneumoniae, HACEK organisms (Haemophilus species, Actinobacillus actinomycetemcomitans, Cardiobacterium hominis, Eikenella corrodens, and Kingella species), and enterococcus species.4-6 Emergence of antibiotic resistance to these common pathogens has serious ramifications for the morbidity and mortality of IE. It is therefore essential that pediatricians and pediatric cardiologists work in concert with specialists in infectious diseases in planning the treatment of IE. SN - PB - The McGraw-Hill Companies CY - New York, NY Y2 - 2024/03/29 UR - accesspediatrics.mhmedical.com/content.aspx?aid=7048695 ER -